title: General health and state anxiety in patients recovering from colorectal cancer surgery.
abstract: OBJECTIVE
  To describe and compare general health and state anxiety before surgery and up to 6 months after surgery in patients with colorectal cancer undergoing elective rectal resection, abdominoperineal resection or colonic resection in an enhanced recovery context.
  
  
  BACKGROUND
  Little is known about patient-reported health and anxiety after colorectal cancer surgery in an enhanced recovery context.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Data were collected from October 2011-February 2013. The questionnaires - EuroQol 5-Dimensions 3-Levels and State-Trait Anxiety Inventory - were answered before surgery, at discharge and 1 and 6 months after surgery. Data were analysed using inferential statistics to describe differences between groups of patients (Kruskal-Wallis test) and between assessments within groups (Friedman's anova).
  
  
  RESULTS
  Patients (N = 105), divided into three groups based on surgical procedure, showed a high health index and a low state anxiety in all assessments without differences between the groups. Patients considered for abdominoperineal resection rated their pre-operative health as significantly higher than patients after rectal and colonic resections did. Within groups, patients recovering from abdominoperineal resection and rectal resection deteriorated significantly in health index 1 month after surgery. However, after 6 months they had improved again. After colonic resection, patients improved significantly in self-rated health and anxiety 1 month after surgery with no further discernible improvement after 6 months.
  
  
  CONCLUSIONS
  The study showed that patients generally had a high level of health and a low level of anxiety throughout the study period. Only a few differences occurred between assessments within groups.
authors.affiliation: Department of Care Science, Malmö University, Sweden.|Department of Surgery, Skane University Hospital, Malmö, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Jakobsson
authors.affiliation: Department of Care Science, Malmö University, Sweden.|Department of Intensive Care and Perioperative Medicine, Skane University Hospital, Malmö, Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Idvall
authors.affiliation: Department of Care Science, Malmö University, Sweden.
authors.forename: Christine
authors.initials: C
authors.lastname: Wann-Hansson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome
keywords: EQ-5D-3L; ERAS; STAI; colorectal cancer; general health; nursing practice; state anxiety; surgery