ABSTRACT

Anxiety before surgery is very common and greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery. Anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms. Recent work in psycho-neuro-immunology has demonstrated that stress delays wound healing.  Surgery is a threatening experience, with multiple stressful components--concerns about one's physical condition, admission to a hospital, anticipation of painful procedures, worries about survival and recovery, and separation from family. Accordingly, it is not surprising that even operations that physicians consider "minor" can provoke strong emotional reactions in patients (Johnston, 1988). If these psychological responses are sufficiently intense, they can have important consequences: The weight of the evidence suggests that greater distress or anxiety prior to surgery is associated with a slower and more complicated postoperative recovery (Johnston & Wallace, 1990; Mathews & Ridgeway, 1981).