title: Social connectedness and patient recovery after major operations.
abstract: BACKGROUND
  Social connectedness is thought to play an important role in overall health and well being. We hypothesized that social network size and other measures of social connectedness would predict perceived pain intensity, unpleasantness, and anxiety in veterans recovering after major thoracic or abdominal operations and influence postoperative complications and length of stay.
  
  
  METHODS
  Six hundred five patients from two Veterans Affairs' medical centers who participated in a randomized controlled trial of massage as adjuvant treatment for postoperative pain were the subjects of this study. Subjects' social networks were assessed by the numbers of friends or relatives an individual had and how frequently contact was made with members of their social network. Subjective outcomes were rated with visual analogue scales for 5 postoperative days. Daily opiate use, postoperative complications, and length of stay were also recorded.
  
  
  RESULTS
  Mean (+/-SD) age was 63.8 years (+/-10.2 years) and 98.5% of participants were men. Those reporting a greater social network were older and had lower preoperative pain intensity, unpleasantness, and state and trait anxiety (p < 0.001). Considerably less pain intensity, unpleasantness, and opiate use were associated with increasing social network size during the first 5 postoperative days. After adjusting for preoperative values of pain and anxiety, these relationships were no longer statistically significant. Smaller social network size was associated with the likelihood of length of stay >or= 7 days (p = 0.03).
  
  
  CONCLUSIONS
  These findings suggest that the effect of social networks on surgical outcomes can be mediated by their effect on levels of preoperative pain and anxiety. Patients should be screened preoperatively for pain and anxiety because these are strong predictors of a more difficult postoperative recovery.
authors.affiliation: Center for Practice Management and Outcomes Research, Health Services Research and Development, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Allison R
authors.initials: AR
authors.lastname: Mitchinson
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: Michael
authors.initials: M
authors.lastname: Geisser
authors.forename: Jack M
authors.initials: JM
authors.lastname: Rosenberg
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Hinshaw
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001008:Anxiety Disorders / Q000209:etiology / Q000517:prevention & control*; D003866:Depressive Disorder / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008405:Massage; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D020127:Recovery of Function; D012944:Social Support; D019616:Thoracic Surgical Procedures / Q000009:adverse effects* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid