Predictors of Recovery Expectancy in Preparation for Pelvic Reconstructive Surgery in Women With Pelvic Organ Prolapse: A Prospective Cohort Study.

Abstract

Recovery expectancy is a modifiable predictor of actual recovery after surgery. Identifying predictors of recovery expectancy will allow clinicians to preoperatively modify recovery expectancy and optimize actual recovery. The primary objective was to identify patient characteristics that predict a patient's recovery expectancy. The secondary objective was to validate previous research demonstrating that recovery expectancy predicted actual recovery. This is a prospective cohort study of women undergoing pelvic reconstructive surgery. Patients completed a preoperative survey to collect data on potential sociodemographic, clinical, and psychosocial, including investment in life roles, predictors of recovery expectancies. Actual recovery was measured at postoperative weeks 2 and 6. Predictors of recovery expectancy were identified. Two hundred one women were recruited with 174 included in the final analysis. Variables significantly associated with recovery expectancy during bivariate analysis (P < 0.05) were education level, total prior surgical procedures, pelvic pain, back pain, bodily pain, sick role investment, optimism, satisfaction with participation in social roles, overall social support, job satisfaction, and professionalism. Sick role investment was the only independent predictor of recovery expectancy (F = 3.46, df = 13, P < 0.001). Greater sick role investment was associated with increased probability of prolonged recovery. Patients with low recovery expectancies had less actual recovery compared with patients with high recovery expectancies (P = 0.014). This study confirmed prior work that recovery expectancy predicts actual recovery after reconstructive pelvic surgery and may establish recovery expectancy as a mediator between sick role investment and actual postdischarge surgical recovery.