title: Dispositional pessimism predicts delayed return to normal activities after inguinal hernia operation.
abstract: BACKGROUND
  The traditional outcome measure to assess effectiveness of inguinal hernia operation was recurrence. Open mesh repair has reduced recurrence rates and attention is now turning to outcomes other than recurrence. The factors influencing the large variation in reported times of resumption of normal activities after inguinal hernia repair are many and diverse. The human factors influencing resumption of normal activity are rarely reported.
  
  
  METHODS
  We undertook a prospective study of 206 patients undergoing primary inguinal hernia repair in an ambulatory setting in a public hospital to ascertain whether dispositional outlook on life affected resumption of normal activity after hernia repair. Outlook on life was assessed using the life orientation test. An independent observer assessed the patients preoperatively and determined timing of resumption of normal activities.
  
  
  RESULTS
  Regression analysis showed a highly significant relationship between delayed return to normal activity and dispositional pessimism (P =.0004).
  
  
  CONCLUSIONS
  Dispositional pessimism correlates strongly with delayed return to normal activities. Further studies of this kind will help to elucidate the human factors that affect recovery after operation. Studies which use return to normal activities as a measure of the outcome of a surgical technique should include an assessment of the patient's preoperative outlook on life. Surgeons should consider the personality of the patient presenting for groin hernia repair and may wish to tailor their counseling accordingly.
authors.affiliation: Department of General Surgery, Derriford Hospital, University of Plymouth, Plymouth, United Kingdom.
authors.forename: Douglas M G
authors.initials: DM
authors.lastname: Bowley
authors.forename: Mike
authors.initials: M
authors.lastname: Butler
authors.forename: Stephen
authors.initials: S
authors.lastname: Shaw
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Kingsnorth
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003376:Counseling; D005260:Female; D006552:Hernia, Inguinal / Q000401:mortality / Q000523:psychology* / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009341:Negativism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires