title: The Effectiveness of Psychosocial Interventions as Adjuncts to Orthopaedic Surgery: A Systematic Review Protocol.
abstract: Pain and anxiety are commonly reported among those undergoing orthopaedic surgery. Improvement in anxiety and pain control might be achieved by supplementing standard care with psychological interventions. However, the effectiveness of adjunctive psychosocial interventions in anxiety and pain control have not been addressed sufficiently by previous systematic reviews in orthopaedic surgeries. The present study aimed to assess the effectiveness of adjunctive psychosocial techniques to improve perioperative clinical care in orthopaedic surgery, to identify the most effective intervention types and to evaluate potential moderators.
  
  
  
  We will perform a systematic review and meta-analysis to address the study aims. PubMed, PsycINFO, CINAHL and ProQuest Dissertations & Theses will be searched between 1980 and 2015. Prospective controlled clinical trials completed in adults, contrasting standard care and standard care supplemented with psychosocial methods, will be eligible for inclusion. Effectiveness will be assessed through the outcomes of postoperative pain intensity, analgesic requirement, perioperative anxiety, quality of life and postoperative recovery. The results of a random-effect meta-analysis will be reported. To aid implementation of best practice, moderating effects of the type and timing of psychosocial intervention, type of surgical intervention and type of anaesthesia will be evaluated through meta-regression. Sensitivity analyses and subgroup contrasts will follow as necessary.
  
  
  
  Recommendations will be made to improve medical care in orthopaedic procedures. The quality of evidence will be rated using GRADE criteria. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kekecs
authors.affiliation: Department of Orthopedic Surgery, University of Debrecen, Clinical Center, Debrecen, Hungary.
authors.forename: Csenge
authors.initials: C
authors.lastname: Szeverenyi
authors.affiliation: Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
authors.forename: Alisa
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Elkins
authors.affiliation: Department of Orthopedic Surgery, University of Debrecen, Clinical Center, Debrecen, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Csernatony
authors.affiliation: Institute of Psychology, Eotvos Lorand University, Budapest, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Varga
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D001521:Behavior Therapy; D006801:Humans; D019637:Orthopedic Procedures / Q000523:psychology*; D010149:Postoperative Pain / Q000517:prevention & control; D000072858:Psychosocial Support Systems; D012107:Research Design; D000078202:Systematic Reviews as Topic
keywords: orthopaedic surgery; prospective controlled trials; psychological interventions, patient education