Friends, Family & Post-surgical Outcomes

An article in this week’s Journal of the American College of Surgeons shows that “patients with larger social networks showed better outcomes than patients with small or nonexistent social networks.” Here is the abstract (note: the first time I clicked through to the site I was able to access the full-text version but now I can’t).

Surgical patients with a strong network of friends & family reported better scores for anxiety, depression, inner peace, relaxation, pain intensity and pain unpleasantness for every day of the five post-surgical follow-up days. They needed fewer painkillers and were less likely than other patients to stay in the hospital longer than 7 days. Interestingly, attending a weekly social function had a more significant effect than attending a weekly worship service (which, as the authors write “underscores the need to control for social interactions in general when studying the effect of religious observance on health,” but as I would write, you can’t just go and sit in the pew to get the benefits).

It was a sample of elderly men, and therefore the authors plead for caution in extrapolating from the findings, but I think it’s certainly worth a discussion: What is technology’s role? What is the effect of a supportive online community, in addition to the off-line friends & family measured in most studies? Is the social network effect wholly positive? Or are there hidden dangers? Is there a hierarchy of salutary “social functions”?


Posted in: patient networks





10 Responses to “Friends, Family & Post-surgical Outcomes”

  1. Hi Susannah,
    Did you get my email about this: ?

    Another example of patients with larger social networks showing better outcomes :)

    – AmyT

  2. Susannah Fox says:

    Thanks, Amy! I just found it in my spam inbox — sorry it got caught there. Your story is indeed a great example of a strong social (online) network.

  3. Sara says:

    I wonder how much physical contact is a part of the equation. It certainly came up a lot in this piece I did last year:

    Anyway–glad to see you are blogging! Was much needed.

  4. Susannah Fox says:

    Funny you should mention physical contact! The study sample was drawn from a randomized controlled trial of massage as treatment for post-op pain. One group received standard care, another group got a visit from a massage therapist (but no massage), and a third group got a visit from a massage therapist that included a massage. For the social-connectedness part of the study, all treatment groups were combined.

    The authors did write that there was a “potential self-selection bias…as patients who were not interested in being touched refused to participate, although more than two-thirds of eligible patients were willing to be touched. It is possible that patients who refused to participate were also more anxious and in greater pain than those who did participate.”

  5. I’m just catching up on this. I confess I’m a little befuddled by this. Does a social network help?? Hello?

    First, in my online community (on CaringBridge), I had posts from a hundred people, from my high school years through college and co-workers and beyond … some were people I’d only heard of and some I didn’t even know that well. It was *phenomenal* hearing that so many people were pulling from me. My story is just one data point, but when my symptoms were at their worst, my recovery speed and painkiller use were minimal, from what I’ve heard. And subjectively it just made a huge difference to know that a lot of people were waiting to hear how I was doing.

    Second, I think that answers the question about the role of technology.

    Third, isn’t there a hefty body of research showing that (a) connectedness boosts the immune system, and (b) a stronger immune system correlates with a better patient experience, reduced pain, and quicker recovery? Maybe not, but I thought I’d read things over the years that made that obvious. Either way, it would be useful to construct a set of links to build that case (or encourage research into whether it’s true).

    As for self-selection, that’s statistically worth asking; I suspect that people who have more social connectedness probably are more willing to be touched. So I’d like to see these outcomes from a similar mix of social network size that didn’t receive massage therapy.

    In fact that makes me scratch my head – did they say why they selected a population of people who got massages??

    Re “elderly men,” watch yer language. :)

  6. Susannah Fox says:

    Sorry, Dave! “Elderly male veterans” was the phrase used in the study, but you’re right, I should use the AARP-approved adjective “older” in my posts. The mean age for the 605 respondents was 63.8 years (+/- 10.2 years) and 98.5% were men.

    As for the literature, here’s the first line of the article: “A consistent body of evidence suggests that social connectedness impacts health and well being” (and 7 citations are listed as proof, ranging from a 1979 mortality study to a 1989 depression study to a 1992 stroke study, for example.) What’s new here (I glean) is that they focused on surgery as the event and dug down a bit deeper on the “social functions” (other than worship services) that patients participate in.

    I still want to know some examples of those social functions — bowling leagues? a weekly poker game? sitting on a park bench with a pal?

  7. I’m just so amused at how established medical language shows up in ordinary human discourse. Cripes, I don’t qualify for a single seniors discount anywhere, but in that article (though I’m 1/2 a sigma below their mean) I’m elderly, eh?

    But I suppose the shoe’s on the other foot now – not long ago a first-time mother above age *35* was called an elderly prima gravida. Sheesh. :)

  8. erin says:

    I’m not surprised by this at all.. I basically have no friends, and only one has bothered to visit me after my extensive knee surgery, and I’m suffering from severe post surgical depression. I am becoming increasingly worse, and don’t doubt that a lot of that has to do with the lack of any social life.. my husband is my only social interaction, and he’s tired of me being so down.

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