Doctoral thesis examines determinants in surgical patient care

A doctoral thesis at Kenitra's Faculty of Science, affiliated with Ibn Tofail University, has delved into the multifaceted determinants influencing the surgical patient's journey. Researcher Mustafa Amzout, under the supervision of Professor Aouane El Mahjoub, investigated "Analysis of Social, Economic, and Medical Determinants in the Admission and Preparation Pathway for Surgery."

The research underscores that challenges surrounding pre- and post-operative periods extend beyond purely physiological aspects. It incorporates psychological and cognitive dimensions that directly affect patients' quality of life and resilience. Factors such as anxiety, dysfunctional thought patterns, sleep disturbances, and pain were identified as crucial elements influencing patient experience and recovery.

Amzout's study analyzed these psychological, cognitive, and physiological determinants in 1,040 patients using validated tools. These included the Early Maladaptive Schemas Questionnaire (EMS), the Perceived Stress Scale, the Montreal Cognitive Assessment (MoCA), and pain assessment scales. The goal was to establish a robust scientific foundation for developing therapeutic protocols tailored to the psychological needs of surgical patients, aiming to enhance not only physical recovery but also psychological well-being and adaptation.

Key findings revealed a significant prevalence of maladaptive cognitive schemas among participants, with moderate schemas affecting 62 percent. While specific strengths like emotional security and cognitive/social competencies were noted, weaknesses such as excessive control, over-performance, and self-sacrifice were also identified. Regarding sleep, one-third of patients awaiting surgery rated their sleep as "very good," but a substantial 21 percent reported disturbed sleep, potentially impacting post-operative recovery. Furthermore, 42 percent of patients felt overwhelmed by unexpected events prior to surgery, with administrative procedures contributing to stress for many.

Cognitive performance post-surgery showed variations based on gender, age, and education level, with women, the elderly, and less educated patients appearing more vulnerable and requiring specialized follow-up. Pain assessments indicated moderate to high intensity for many patients, with treatments providing partial relief for 58 percent. The thesis proposes an integrated approach, identifying early maladaptive schemas as vulnerability factors influencing pre-surgical stress, sleep quality, and pain-related cognitive and emotional processes. Perceived stress and sleep disturbances were found to mediate the severity of pain, post-surgical cognitive function, and overall patient adaptation.