Stress symptoms among adolescents before and after scoliosis surgery: correlations with postoperative pain

J Clin Nurs. 2016 Apr;25(7-8):1086-94. doi: 10.1111/jocn.13137. Epub 2016 Feb 22.


Aims and objectives: 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.

Design: 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.

Relevance to clinical practice: 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.

Keywords: adolescent; anxiety; idiopathic scoliosis; pain; perioperative; stress symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Anxiety / etiology
  • Anxiety / psychology
  • Depression / diagnosis
  • Depression / etiology
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / psychology*
  • Postoperative Period
  • Prospective Studies
  • Scoliosis / psychology*
  • Scoliosis / surgery*
  • Self Report
  • Stress, Psychological / diagnosis
  • Stress, Psychological / etiology*
  • Stress, Psychological / prevention & control