title: The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial.
abstract: BACKGROUND
  Fatigue is one of the main complaints after surgery and may last longer than physical symptoms. It prevents return to normal function and activity. Relaxation interventions, performed prior to abdominal surgery, have been shown to reduce pain, wound erythema, and systemic cortisol levels. However, there is a lack of data on the impact of this intervention on patient well-being, functional recovery, activities of daily living, and fatigue after discharge from hospital.
  
  
  METHODS
  The study was a randomised single-blinded trial. Patients who were to undergo elective laparoscopic cholecystectomy for any indication between April 2008 and May 2010 were screened for inclusion. Those in the intervention group attended a standardised 45 min relaxation session with a health psychologist and were given relaxation exercise CDs to take home. The control group did not have the intervention. Patients were followed for 30 days. Fatigue was measured using the identity-consequence fatigue scale.
  
  
  RESULTS
  Seventy-five patients were randomised. Fifteen patients were excluded after randomization for various reasons; hence, 60 patients were followed up and analysed. Both groups had similar fatigue at baseline. There was improved fatigue and consequence of fatigue on postoperative day 30 in the intervention group. There was no difference in fatigue at any other time point postoperatively.
  
  
  CONCLUSIONS
  This was the first interventional study targeting fatigue after laparoscopic cholecystectomy by using a brief psychological relaxation intervention. It has shown a reduction of fatigue and impact of fatigue at 30 days postoperatively in the intervention group.
authors.affiliation: Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, PO Box 93311, Otahuhu, Auckland, New Zealand. arman.kahokehr@gmail.com
authors.forename: Arman
authors.initials: A
authors.lastname: Kahokehr
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Broadbent
authors.forename: Benjamin R L
authors.initials: BR
authors.lastname: Wheeler
authors.forename: Tarik
authors.initials: T
authors.lastname: Sammour
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005221:Fatigue / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life; D012064:Relaxation Therapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult