Self-efficacy is an independent predictor for postoperative six-minute walk distance after elective open repair of abdominal aortic aneurysm

Abstract

Objectives: Open surgery is performed to treat abdominal aortic aneurysm (AAA), although the subsequent surgical stress leads to worse physical status. Preoperative self-efficacy has been reported to predict postoperative physical status after orthopedic surgery; however, it has not been sufficiently investigated in patients undergoing abdominal surgery. The purpose of the present study is to investigate the correlation between preoperative self-efficacy and postoperative six-minute walk distance (6MWD) in open AAA surgery.

Methods: Seventy patients who underwent open AAA surgery were included. Functional exercise capacity was measured using preoperative and 1 week postoperative 6MWD. Self-efficacy was preoperatively measured using self-efficacy for physical activity (SEPA). The correlations of postoperative 6MWD with age, height, BMI, preoperative 6MWD, SEPA, Hospital Anxiety and Depression Scale (HADS) score, operative time, and blood loss were investigated using multivariate analysis.

Results: Single regression analysis showed that postoperative 6MWD was significantly correlated with age (r = −0.553, p ≤ 0.001), height (r = 0.292, p = 0.014), Charlson’s comorbidity index (r = −0.268, p = 0.025), preoperative 6MWD (r = 0.572, p ≤ 0.001), SEPA (r = 0.586, p ≤ 0.001), and HADS-depression (r = −0.296, p = 0.013). Multiple regression analysis showed that age (p = 0.002), preoperative 6MWD (p = 0.013), and SEPA (p = 0.043) score were significantly correlated with postoperative 6MWD.

Conclusions: Self-efficacy was an independent predictor for postoperative 6MWD after elective open AAA surgery. This suggests the importance of assessing not only physical status but also psychological factors such as self-efficacy.

Implications for Rehabilitation

• Preoperative self-efficacy has been limited to reports after orthopedic surgery.

• We showed that preoperative self-efficacy predicted postoperative 6MWD after AAA surgery.

• Treatment to improve self-efficacy might be useful in patients receiving AAA surgery in rehabilitation.

Keywords:

• Self-efficacy
• physical function
• rehabilitation
• physical therapy
• postoperative recovery

Disclosure statement

The authors certify that no affiliation or financial involvement exists between them and any organization with a direct interest in the subject matter or materials discussed in the article.

This study was approved by the Ethics Committee of Nagoya University Hospital.