Nail surgery: the effect of clinical and psychological characteristics on post-surgical quality of life and pain severity

Abstract

Nail disease and nail surgery are commonly perceived as painful and distressful experiences that can significantly affect patient health-related quality of life. A comprehensive management of patients undergoing dermatological surgery could improve their emotional experience, influence quality of life and, hopefully, improve their adaptation to the intervention. This study aimed to investigate whether patient psychological characteristics may relate to nail intervention procedures and influence post-surgical quality of life and pain severity. This prospective observational monocentric cohort study was conducted in the Dermatology Nail Unit of Bologna. Patient candidates for nail surgery, meeting the inclusion criteria, were invited to participate in the study which consisted of completion of a self-report questionnaire before (Time 1) and one month after (Time 2) surgery. Nail surgery was performed for 102 patients: 46 underwent highly invasive and 56 mildly invasive nail procedures. In total, 46 nail tumours were excised which were shown to be benign in 36 cases and malignant in 10 cases. Patients with a high level of pain sensitivity and trait of anxiety reported significantly lower levels of quality of life and high levels of pain intensity one month after surgery (p < 0.001). Our findings highlight the need for clinicians to consider the psychological characteristics of patients following dermatological surgery care in order to balance the negative impact of trait anxiety, pain sensitivity and negative treatment expectations regarding post-surgery quality of life and pain severity.