Relationship Between Anxiety Levels, Care Dependency, and Quality of Recovery in Patients Undergoing Orthopedic Surgery.

Background and

Objectives

Postoperative recovery after orthopedic surgery is associated with psychological and functional factors, yet the independent associations of anxiety and care dependency with postoperative recovery remain unclear. This study aimed to identify factors independently associated with postoperative quality of recovery and to examine the relationships among anxiety, care dependency, and recovery quality.

Methods

This analytical cross-sectional study included 155 patients who underwent orthopedic surgery. Data were collected on the first postoperative day using a Patient Identification Form, the Beck Anxiety Inventory, the Care Dependency Scale, and the Quality of Recovery-40 (QoR-40) questionnaire through face-to-face interviews. Data were analyzed using descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Spearman's rank correlation, and multivariable linear regression analyses.

Results

Older age, female sex, and hypertension and/or diabetes mellitus were significantly associated with higher anxiety and greater care dependency (p < 0.05), whereas older age was significantly associated with poorer quality of recovery (p < 0.05). Anxiety was negatively correlated with quality of recovery (r = -0.707, p < 0.001) and functional independence (r = -0.367, p < 0.001), whereas functional independence was positively correlated with quality of recovery (r = 0.557, p < 0.001). Multivariable linear regression analysis showed that higher anxiety (β = -0.52), greater functional independence (β = 0.31), and older age (β = -0.18) were independently associated with quality of recovery.

Conclusions

Older age, female sex, and hypertension and/or diabetes mellitus were independently associated with higher anxiety and greater care dependency. Higher anxiety and lower functional independence were independently associated with poorer postoperative recovery. These findings support the integration of psychological assessment and functional evaluation into routine postoperative nursing care.