Published online Aug 19, 2026. doi: 10.5498/wjp.118942
Revised: March 21, 2026
Accepted: April 24, 2026
Published online: August 19, 2026
Processing time: 141 Days and 18.1 Hours
Orthopedic surgery often induces perioperative anxiety and depression owing to pain, functional limitations, and uncertainty regarding outcomes, which may exacerbate physiological stress responses, impair hemodynamic stability, and hinder postoperative recovery. While psychological support is typically provided preoperatively in wards, psychological distress often peaks in the operating room immediately before anesthesia induction, a critical period frequently overlooked in structured interventions. We hypothesize that implementing a standardized, multidimensional psychological support protocol within the operating room during this critical window can effectively reduce perioperative anxiety and depression and accelerate recovery in orthopedic patients.
To evaluate the impact of an operating room-based psychological intervention on perioperative anxiety, depression, and recovery in orthopedic patients.
This retrospective study included 150 orthopedic surgery patients at the Henan Provincial People’s Hospital. Patients were divided into control (routine care, n = 75) and intervention (operating room psychological intervention, n = 75) groups. Anxiety Self-rating Anxiety Scale (SAS), depression Self-rating Depression Scale (SDS), pain (Visual Analog Scale), recovery time, and patient satisfaction were measured and compared. Logistic regression analysis was performed to identify factors affecting postoperative anxiety and depression.
The intervention group demonstrated lower postoperative anxiety and depression than the control group, with SAS scores of 49.00 (46.00-49.00) vs 49.00 (49.00-54.00) (P = 0.001), SDS scores of 50.00 (47.00-51.00) vs 52.00 (50.00-54.00) (P < 0.001). Postoperative pain was lower in the intervention group [5.00 (5.00-6.00) vs 6.00 (5.00-7.00) (P = 0.001)]. Recovery improved with shorter incision healing time [12.00 (11.00-13.00) days vs 13.00 (12.00-14.00) days, P < 0.001] and reduced hospital stay [7.00 (6.00-8.00) days vs 8.00 (7.00-9.00) days, P = 0.005]. Patient satisfaction was higher (Z = -2.585, P = 0.010). Multivariate analysis confirmed the intervention as protective against postoperative anxiety and depression (odds ratio = 0.252, 95% confidence interval: 0.099-0.639).
Operating room-based psychological intervention effectively reduces perioperative anxiety and depression, alleviates postoperative pain, accelerates recovery, and enhances satisfaction in orthopedic patients, representing a valuable non-pharmacological adjunct to perioperative care.
Core Tip: This study highlights the clinical value of implementing a structured, multidimensional psychological intervention in the operating room during the critical pre-anesthesia period for orthopedic patients. This targeted protocol effectively reduced perioperative anxiety and depression, mitigated postoperative pain, shortened recovery time, and improved patient satisfaction. It serves as an independent protective factor against postoperative psychological distress, offering a practical, nonpharmacological strategy to optimize perioperative outcomes, especially in high-risk patients with multiple psychological vulnerability factors.