The Impact of Psychological Resilience on Fear of Pain and Activity Recovery in Post-Surgical Patients: An Observational Cohort Study.

Background: Fear of pain (FOP) and fear avoidance belief (FAB), play a crucial role in the occurrence and development of chronic pain. However, the dynamics of these factors in post-surgical pain appear to differ, with FOP often learned from others rather than directly caused by painful experiences. Psychological resilience refers to an individual's capacity to adapt effectively to adversity, challenges, and threats, and may play a significant role in overcoming FOP and avoidance behavior.

Objective: The aim of this study was to investigate the role of psychological resilience in overcoming FOP and avoidance behavior among surgical patients undergoing lung surgery.

Methods: Participants were recruited at Wuhan union hospital. Psychological resilience was measured using the Connor-Davidson Resilience Scale. FOP was assessed using the simplified Chinese version of the Fear of Pain-9 items. FAB was measured using the Physical Activity subscale of the Fear-Avoidance Beliefs Questionnaire. Activity recovery was assessed through questions related to social activities and household responsibilities. Adaptive Lasso regression analysis under nested cross-validation was used to identify key factors affecting postoperative FOP and activity recovery.

Results: A total of 144 participants were included in the final analysis. The results showed that preoperative FOP (coefficient =8.620) and FAB (coefficient =8.560) were mainly positively correlated with postoperative FOP, while psychological resilience (coefficient =-5.822) and age (coefficient =-2.853) was negatively correlated with it. The model explains an average 73.1% of the variance. In predicting activity recovery, psychological resilience was the most important factor, and the model obtained an average accuracy of 0.820 ± 0.024 and an average AUC of 0.926 ± 0.044.

Conclusions: Psychological resilience is negatively associated with postoperative FOP and positively with activity recovery in lung surgery patients. Patients with higher resilience are more likely to cope effectively with post-surgical pain and recover activities sooner. These findings highlight the importance of assessing and potentially enhancing psychological resilience in the perioperative period to improve postoperative outcomes.

Clinicaltrial: Registration Number: ChiCTR2200056651.