@article{Rathnakumari2026,
abstract = {INTRODUCTION: Postoperative recovery is traditionally managed via a biomedical framework prioritizing pain control. However, psychological distress, including anxiety and depression, is highly prevalent and often exists independently of physical symptoms. This narrative review synthesizes recent global evidence (2021–2026) to examine the psychosocial determinants of postoperative distress, specifically emotional regulation, coping mechanisms, and social support across diverse healthcare contexts. MATERIALS AND METHODS: A systematic search was conducted across PubMed, Google Scholar and the Web of Science. Study selection followed PRISMA principles, focusing on peer-reviewed primary research and systematic reviews involving adult surgical populations. Data were extracted regarding psychological outcomes and psychosocial predictors, then synthesized using a narrative thematic approach. RESULTS: Findings reveal a significant discordance between pain intensity and psychological morbidity; high distress levels persist even with well-controlled pain. Emotional dysregulation and maladaptive coping are core drivers of postoperative anxiety. While perceived social support is a consistent protective buffer, its efficacy is mediated by socioeconomic factors. In LMICs, distress is amplified by financial toxicity and systemic barriers, whereas HICs struggle to integrate psychological care into standardized biomedical pathways. CONCLUSIONS: Postoperative psychological distress is a multifactorial phenomenon that pain scores alone cannot adequately predict. Optimizing global surgical outcomes requires a transition toward a biopsychosocial model that incorporates routine psychological screening, targeted emotional regulation interventions, and context-sensitive social support strategies.},
author = {Rathnakumari, Nirosha},
doi = {10.32114/CCI.2026.9.2.7.19},
journal = {Critical Care Innovations},
number = {2},
pages = {7--19},
title = {{Postoperative psychological distress beyond pain: a narrative review of psychosocial determinants across global surgical settings.}},
url = {https://www.irdim.net/cci/9(2)7-19.html},
volume = {9},
year = {2026}
}