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Acute Pain | Chronic Pain | General

Psychoeducational interventions for surgery

Clinical bottom line:

Psychoeducational interventions improve patient recovery, postoperative pain, psychological distress and length of hospital stay. This review does not make an assessment of whether these improvements are of clinical relevance, or which specific methods of care are effective.

Psychoeducational interventions

Psychosocial support and educational interventions have been used to alleviate patient distress, pain and other aspects of patient wellbeing after surgery.

Systematic review

Devine EC. Effects of psychoeducational care for adult surgical patients: a meta-analysis of 191 studies. Patient Educ Couns 1992; 19:129-42.

Inclusion criteria were trials of psychoeducational care; controlled trials; hospitalised adult patients; surgical intervention; group size at least four; outcome measures to include pain, recovery and/or psychological distress. Non-randomised trials were included in this review. Interventions were divided into three treatment types:

healthcare information (information in preparation for surgery, timing of procedures, functions and roles of healthcare providers, self-care actions, pain/discomfort information)

skills teaching (coughing, breathing and bed exercises, relaxation exercises, hypnosis, cognitive reappraisal)

psychosocial support (identifying/alleviating concerns, reassurance, problem-solving with patient, encouraging questions, increasing frequency of support).

Main analysis was carried out on 173 trials to calculate effect size and directional values. All measures of recovery were analysed together. This was repeated for pain, psychological distress, and for length of stay.


Statistically reliable, small to moderate sized beneficial effects were found on recovery, postoperative pain and psychological distress. The use of effect size makes these results difficult to translate into clinical practice. There was also a decreased length of hospital stay.

Outcome measure No. of measures No. of Trials Effect size Percent trials with significant beneficial effect
Recovery 293 125 0.43 (N=111) 79 to 84
Pain 239 102 0.38 (N=82) 79 to 84
Psychological Distress 222 97 0.38 (N=80) 79 to 84
Length of Stay   76 Decrease by 11% Average 1.5 days 79

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