The Power of the Mind: Psychological Factors, Prehabilitation, and Surgical Outcomes

Undergoing surgery can be a physically and emotionally challenging experience, particularly for those with complex conditions like endometriosis. While physical fitness and nutrition often take the spotlight in surgical preparation, research highlights the critical role of psychological prehabilitation in improving recovery outcomes.

In the below video, Matilda Health co-founder Dr Kevin Wernli (PhD) reviews a fantastic article published in Anaesthesia. The article, by Professor Denny Levett and Dr Chloe Grimmett, titled: "Psychological factors, prehabilitation and surgical outcomes: evidence and future directions" provides a great review of the literature when it comes to the relevance of psychological factors and surgical outcomes, and can be found here: https://doi.org/10.1111/anae.14507

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Matilda Health co-founder, Dr Kevin Wernli (PhD), summarises some key points from the fantastic open access article.

Why Psychological Readiness Matters

Research consistently shows that pre-operative anxiety and depression can negatively affect recovery. High levels of anxiety are linked to worse post-operative pain and longer recovery times. Prehabilitation programs that combine physical exercise, nutrition, and mental health support help reduce these psychological barriers, ultimately leading to better outcomes. According to Levett and Grimmett (2019):

"Pre-operative anxiety, depression, and low self-efficacy are consistently associated with worse physiological surgical outcomes and postoperative quality of life"

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This is one of the reasons why we measure pre-operative anxiety and self-efficacy within the Matilda surgery optimisation program, and why we have evidenced-based strategies like education, mindfulness, relaxation techniques, yoga and more. Our goal is to reduce the chance of persistent pain post-surgery, which can affect up to 70% of major surgery patients (Weinrib et al., 2017)

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Self-Efficacy as a Key to Faster Recovery

Patients who believe in their ability to manage their recovery—known as self-efficacy—tend to recover faster and experience less post-surgical pain. In the article, Professor Denny Levett and Dr Chloe Grimmett discussed the research showing that patients with high self-efficacy recover faster, while those with lower confidence face more prolonged recoveries​. By offering structured education, exercises, and resources, Matilda Health's Surgery Optimisation Program aims to build this belief and empower people to take an active role in their recovery.

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The Power of Holistic Prehabilitation

Traditional prehabilitation often focused solely on the body, but the latest evidence suggests that a holistic approach—one that incorporates mental health alongside physical preparation—is essential for optimal recovery. By combining physical exercise, nutritional guidance, and psychological support,  improvements in both physical and mental resilience ahead of surgery​ can be enjoyed.

At Matilda Health, our Surgery Optimisation Program incorporates yoga, Pilates, mindfulness practices, and education from healthcare professionals, creating a well-rounded prehabilitation process that enhances both physical and psychological readiness and recovery. This approach not only aims to reduce pre-operative anxiety but also helps people feel more empowered and in control during their surgical journey.

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Conclusion

Surgical outcomes are not just determined by physical readiness—mental preparation is just as critical. By addressing both psychological and physical factors, prehabilitation programs like ours help provide people with the tools they need to recover faster, experience less pain, have better surgical outcomes, and achieve better overall health post-surgery.

Ready to optimise your (or your patients) surgical journey? Contact us to learn more about our comprehensive support for endometriosis surgery recovery.

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Author: Dr Kevin Wernli (PhD), Pain Physiotherapist and Matilda Co-Founder