Personality rather than clinical variables determines quality of life after major colorectal surgery.
OBJECTIVE
Clinical factors, especially the presence of a stoma, have been presumed to be the major determinants of quality of life after colorectal surgery. We investigated the relative influence of other variables, e.g., patient's personality, sense of coherence, and coping strategies, to determine the validity of this long-held assumption.


METHODS
We investigated 79 patients undergoing major colorectal surgery. Quality of Life was assessed with the Short Form-36 and Gastrointestinal Quality of Life Index questionnaires at three and 12 months postsurgery. Additionally, baseline psychologic data on personality and sense of coherence were assessed. The results were analyzed in both a bivariate manner and by multivariate hierarchical regression analysis.


RESULTS
In the bivariate analysis, clinical parameters had a small and temporary effect on quality of life, if any. In the multivariate model the character of the underlying disease and the presence of a stoma did not affect quality of life significantly. In contrast, emotional lability, extraversion, and sense of coherence had a strong and lasting influence, accounting for 49 percent of variance (Delta R2) for emotional quality of life, 22 percent for physical and 32 percent for disease-specific Quality of Life.


CONCLUSIONS
Personality exerts a strong and lasting effect on quality of life after colorectal surgery. This effect by far exceeds the influence of common clinical variables.
Siassi
Michael
M
University Hospital of Erlangen, Department of General Surgery, Erlangen, Germany. info@siassi.de
Weiss
Maren
M
Hohenberger
Werner
W
Lösel
Friedrich
F
Matzel
Klaus
K
D000223:Adaptation, Psychological; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy; D013505:Digestive System Surgical Procedures; D004239:Diverticulitis, Colonic / Q000601:surgery; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007081:Ileostomy; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010551:Personality; D011184:Postoperative Period; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000601:surgery*; D012810:Sigmoid Diseases / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000601:surgery