title: Optimism in women undergoing abdominal sacrocolpopexy for pelvic organ prolapse.
abstract: BACKGROUND
  Although studies suggest that optimism can predict health outcomes, the relationship has not been tested in women with pelvic organ prolapse (POP). This study sought to explore the relationship between optimism, prolapse severity, and symptoms before operation; and examine whether optimism predicts postsurgical functional status, treatment satisfaction, and treatment success.
  
  
  METHODS
  Data from the randomized Colpopexy and Urinary Reduction Efforts (CARE) study, in which stress continent women undergoing sacrocolpopexy to repair stage II to IV POP completed a baseline assessment of optimism and validated symptom and quality-of-life measures at baseline and 24 months. Relationships between optimism and demographics, clinical status, and functional and quality-of-life outcomes were assessed.
  
  
  RESULTS
  Of 322 Colpopexy and Urinary Reduction Efforts study participants, 305 (94.7%) completed 24-month followup interviews. At baseline, there were no notable differences in optimism with respect to POP stage or history of earlier operations for prolapse or urinary incontinence. At baseline, women with greater optimism reported markedly better physical and mental functioning (p <or= 0.001) and less symptom distress (p <or= 0.01). Two years after operation, the difference in symptom experience across the three optimism categories narrowed; all women reported improved health status, fewer symptoms, and less impact on daily activities. Satisfaction with treatment and perception of treatment success were not associated with optimism.
  
  
  CONCLUSIONS
  In women planning operation for POP, optimism is related to pelvic symptom severity, but is not associated with satisfaction with treatment or treatment success. Abdominal sacrocolpopexy resulted in substantial improvements in quality of life and functional outcomes that were not notably influenced by optimism.
authors.affiliation: Department of Wellness, Health Promotion, and Injury Prevention, School of Health Sciences, Oakland University, Rochester, MI 48309, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Wren
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.forename: Mary P
authors.initials: MP
authors.lastname: FitzGerald
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Barber
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Cundiff
authors.forename: Ingrid E
authors.initials: IE
authors.lastname: Nygaard
authors.forename: Halina M
authors.initials: HM
authors.lastname: Zyczynski
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D000339:Affect; D000368:Aged; D003469:Culture; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D012447:Sacrum / Q000601:surgery*; D012803:Sick Role; D014550:Urinary Incontinence, Stress / Q000523:psychology* / Q000601:surgery*; D014596:Uterine Prolapse / Q000523:psychology* / Q000601:surgery*