Perioperative psychological support in the operating room improves anxiety, depression, and recovery in orthopedic patients

doi:10.5498/wjp.118942

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 118942
Published online Aug 19, 2026. doi: 10.5498/wjp.118942

Table 1 Clinical characteristics, n (%)

Clinical data	Control group (n = 75)	Intervention group (n = 75)	χ²/t	P value
Gender			0.684	0.408
Male	41 (54.67)	46 (61.33)
Female	34 (45.33)	29 (38.67)
Age (years)	61.17 ± 5.96	59.95 ± 5.94	1.263	0.209
Education level			0.329	0.848
Primary school and below	28 (37.33)	31 (41.33)
Junior high school	27 (36.00)	24 (32.00)
High school and above	20 (26.67)	20 (26.67)
Attendant			0.794	0.373
Relatives	61 (81.33)	65 (86.67)
Non-relatives¹	14 (18.67)	10 (13.33)
Average monthly income (Yuan)			0.707	0.4
≤ 5000	49 (65.33)	44 (58.67)
> 5000	26 (34.67)	31 (41.33)
Smoking			0.515	0.473
Have	24 (32.00)	20 (26.67)
No	51 (68.00)	55 (73.33)
Drinking			1.31	0.252
Have	39 (52.00)	32 (42.67)
No	36 (48.00)	43 (57.33)
T2DM			0.743	0.389
Have	28 (37.33)	23 (30.67)
No	47 (62.67)	52 (69.33)
Hypertension			0.35	0.554
Have	15 (20.00)	18 (24.00)
No	60 (80.00)	57 (76.00)
Cause of injury			0.249	0.618
Acute traumatic injury	43 (57.33)	46 (61.33)
Chronic strain and degenerative diseases	32 (42.67)	29 (38.67)
Location of fracture			0.926	0.629
Spinal column	26 (34.67)	31 (41.33)
Limbs	30 (40.00)	29 (38.67)
Others	19 (25.33)	15 (20.00)

¹Includes situations such as being accompanied by a caregiver or not.

T2DM: Type 2 diabetes mellitus.

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Table 2 Anxiety and depression in the two groups

Grouping	SAS		SDS
Grouping	Preoperative	Postoperative	Preoperative	Postoperative
Control group	53.00 (51.00, 58.00)	49.00 (49.00, 54.00)^a	55.00 (53.00, 58.00)	52.00 (50.00, 54.00)^a
Intervention group	54.00 (52.00, 58.00)	49.00 (46.00, 49.00)^a	56.00 (53.00, 58.00)	50.00 (47.00, 51.00)^a
Z	-1.086	-3.386	-0.928	-4.567
P value	0.278	0.001	0.354	< 0.001

^aP < 0.05.

SAS: Self-rating Anxiety Scale; SDS: Self-rating Depression Scale.

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Table 3 Condition of pain

Grouping	VAS		The number of rescue analgesics used during the 48 hours after surgery
Grouping	Preoperative (24 hours)	Postoperative (24 hours)
Control group	5.00 (4.00, 5.00)	6.00 (5.00, 7.00)	2.00 (2.00, 3.00)
Intervention group	5.00 (4.00, 5.00)	5.00 (5.00, 6.00)	2.00 (2.00, 3.00)
Z	-0.537	-3.198	-1.382
P value	0.591	0.001	0.167

VAS: Visual Analogue Scale.

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Table 4 Postoperative rehabilitation

Grouping	Time of first ambulation (hours)	Time of wound healing (days)	Length of hospital stay (days)
Control group	40.00 (31.00, 48.00)	13.00 (12.00, 14.00)	8.00 (7.00, 9.00)
Intervention group	39.00 (31.00, 43.00)	12.00 (11.00, 13.00)	7.00 (6.00, 8.00)
Z	-1.602	-4.426	-2.797
P value	0.109	< 0.001	0.005

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Table 5 Adverse events, n (%)

Grouping	Infection	Bleeding	Venous thrombosis of the lower extremities	Other	Overall incidence
Control group	2 (2.67)	1 (1.33)	2 (2.67)	2 (2.67)	6 (8.00)
Intervention group	1 (1.33)	1 (1.33)	1 (1.33)	2 (2.67)	4 (5.33)
χ²					1.336
P value					0.248

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Table 6 Patients’ satisfaction with nursing work, n (%)

Grouping	Group	Very satisfied	Relatively satisfied	Generally satisfied
Control group	13 (17.33)	31 (41.33)	27 (36.00)	4 (5.33)
Intervention group	28 (37.33)	26 (34.67)	19 (25.33)	2 (2.67)
Z	-2.585
P value	0.010

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Table 7 Univariate analysis of influencing patients’ postoperative anxiety and depression, n (%)

Clinical data	Total	Anxiety and depression group (n = 38)	Non-anxiety and depression group (n = 112)	χ²/t	P value
Gender				0.556	0.456
Male	87 (58.00)	24 (27.59)	63 (72.41)
Female	63 (42.00)	14 (22.22)	49 (77.78)
Age (years)	60.56 ± 5.96	62.84 ± 5.85	59.79 ± 5.82	2.793	0.006
Education level				8.256	0.016
Primary school and below	59 (39.33)	21 (35.59)	38 (64.41)
Junior high school	51 (34.00)	13 (25.49)	38 (74.51)
High school and above	40 (26.67)	4 (10.00)	36 (90.00)
Attendant				9.19	0.002
Relatives	126 (84.00)	26 (20.63)	100 (79.37)
Non-relatives¹	24 (16.00)	12 (50.00)	12 (50.00)
Average monthly income (Yuan)				0.364	0.546
≤ 5000	93 (62.00)	22 (23.66)	71 (76.34)
> 5000	57 (38.00)	16 (28.07)	41 (71.93)
Smoking				0.224	0.636
Have	44 (29.33)	10 (22.73)	34 (77.27)
No	106 (70.67)	28 (26.42)	78 (73.58)
Drinking				0.000	0.996
Have	71 (47.33)	18 (25.35)	53 (74.65)
No	79 (52.67)	20 (25.32)	59 (74.68)
T2DM				3.802	0.051
Have	51 (34.00)	8 (15.69)	43 (84.31)
No	99 (66.00)	30 (30.30)	69 (69.70)
Hypertension				0.552	0.457
Have	33 (22.00)	10 (30.30)	23 (69.70)
No	117 (78.00)	28 (23.93)	89 (76.07)
Cause of injury				2.897	0.089
Acute traumatic injury	89 (59.33)	27 (30.34)	62 (69.66)
Chronic strain and degenerative diseases	61 (40.67)	11 (18.03)	50 (81.97)
Location of fracture				4.37	0.112
Spinal column	57 (38.00)	16 (28.07)	41 (71.93)
Limbs	59 (39.33)	18 (30.51)	41 (69.49)
Others	34 (22.67)	4 (11.76)	30 (88.24)
Type of surgery				11.308	0.004
Major/open surgery	50 (33.33)	20 (40.00)	30 (60.00)
Medium-sized surgery	64 (42.67)	15 (23.44)	49 (76.56)
Small/minimally invasive surgery	36 (24.00)	3 (8.33)	33 (91.67)
Nursing intervention				6.908	0.009
Control group	75 (50.00)	26 (34.67)	49 (65.33)
Intervention group	75 (50.00)	12 (16.00)	63 (84.00)

¹Includes situations such as being accompanied by a caregiver or not.

T2DM: Type 2 diabetes mellitus.

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Table 8 Variable assignment

Variables	Assignment of value
Dependent variable
Postoperative anxiety and depression	1 = anxiety and depression, 0 = non-anxiety, and depression
Independent variables
Age	Enter actual values
Education level	2 = primary school and below, 1 = junior high school, and 0 = high school and above
Attendant	1 = relatives and 0 = non-relatives
Type of surgery	2 = major/open surgery, 1 = medium sized surgery, and 0 = small/minimally invasive surgery
Nursing intervention	1 = control group and 0 = intervention group

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Table 9 Multivariate analysis of influencing factors of anxiety and depression in patients

Variables	β	SE	χ²	P value	OR	95%CI
Age	0.085	0.041	4.395	0.036	1.089	1.006-1.179
Education level (high school and above)				-	1	-
Junior high school	1.189	0.711	2.798	0.094	3.285	0.815-13.240
Primary school and below	1.484	0.694	4.572	0.032	4.410	1.132-17.185
Attendant	1.182	0.520	5.155	0.023	3.260	1.175-9.042
Type of surgery (small/minimally invasive surgery)				-	1	-
Medium-sized surgery	1.246	0.743	2.814	0.093	3.478	0.811-14.919
Major/open surgery	2.249	0.755	8.872	0.003	9.475	2.158-41.611
Nursing intervention	-1.379	0.476	8.410	0.004	0.252	0.099-0.639
Constant	-8.516	2.761	9.511	-	-	-

OR: Odds ratio; CI: Confidence interval.

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Citation: Yuan Y, Liu L, Li WX, Xu L, Chen ZX, Zhang JJ. Perioperative psychological support in the operating room improves anxiety, depression, and recovery in orthopedic patients. World J Psychiatry 2026; 16(8): 118942
URL: https://www.wjgnet.com/2220-3206/full/v16/i8/118942.htm
DOI: https://dx.doi.org/10.5498/wjp.118942

Yuan Y, Liu L, Li WX, Xu L, Chen ZX, Zhang JJ. Perioperative psychological support in the operating room improves anxiety, depression, and recovery in orthopedic patients. World J Psychiatry 2026; 16(8): 118942 [DOI: 10.5498/wjp.118942]

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