title: Stress symptoms among adolescents before and after scoliosis surgery: correlations with postoperative pain.
abstract: OBJECTIVE
  The aim of this study was to describe stress symptoms among adolescents before and after scoliosis surgery and to explore correlations with postoperative pain.
  
  
  BACKGROUND
  Scoliosis surgery is a major surgical procedure. Adolescent patients suffer from preoperative stress and severe postoperative pain. Previous studies indicate that there is a risk of traumatisation and psychological complications during the recovery period.
  
  
  METHODS
  A prospective quantitative cohort study with consecutive inclusion of participants.
  
  
  METHODS
  A cohort of 37 adolescent patients aged 13-18. To assess the adolescents' experiences before surgery and at six to eight months after surgery, the Trauma Symptom Checklist for Children - Alternative version, Youth Self-Report and Kiddie Schedule for Affective Disorder and Schizophrenia for children 12-18 were used. The Visual Analogue Scale was used for self-report of postoperative pain on day three.
  
  
  RESULTS
  Rates of anxiety/depression and internalising behaviour were significantly higher before surgery than six months after. Preoperative anger, social problems and attention problems correlated significantly with postoperative pain on day three. At follow-up, postoperative pain correlated significantly with anxiety, social problems and attention problems.
  
  
  CONCLUSIONS
  The results of this study indicate a need for interventions to reduce perioperative stress and postoperative pain to improve the quality of nursing care.
  
  
  CONCLUSIONS
  Attention to preoperative stress and implementation of interventions to decrease stress symptoms could ameliorate the perioperative process by reducing levels of postoperative pain, anxiety, social and attention problems in the recovery period.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Anna-Clara
authors.initials: AC
authors.lastname: Rullander
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lundström
authors.affiliation: Department of Statistics, Umeå University, Umeå, Sweden.|Departments of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Lindkvist
authors.affiliation: Department of Clinical Sciences, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hägglöf
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Viveca
authors.initials: V
authors.lastname: Lindh
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D011184:Postoperative Period; D011446:Prospective Studies; D012600:Scoliosis / Q000523:psychology* / Q000601:surgery*; D057566:Self Report; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control
keywords: adolescent; anxiety; idiopathic scoliosis; pain; perioperative; stress symptoms