Document Type : RESEARCH PAPER
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Background: Orthopedic surgeons are sometimes hesitant to assess and address psychosocial factors.
Surgeon-specific modifiable factors may contribute to surgeon attitudes and beliefs regarding the mental and
social aspects of illness. A better understanding of these factors could help inform interventions to support
surgeons and improve patient outcomes. We aimed to investigate whether orthopedic surgeons’ self-reported
compassion, perceived stress, and experiential avoidance are independently associated with various surgeon
attitudes and beliefs regarding psychosocial aspects of health.
Methods: This is a cross-sectional study of 165 members of the Science of Variation Group (SOVG).
Surgeons completed measures of compassion, stress, experiential avoidance, and demographics. They
answered questions addressing attitudes and beliefs regarding psychosocial aspects of care, which were
condensed to the following 6 dimensions through factor analysis: (1) confidence, (2) perceived resource
availability, (3) blame towards patients, (4) fear of offending patients, (5) professional role resistance, and
(6) fear of negative patient reactions. We performed 6 multivariable hierarchical regression analyses to
determine whether self-reported compassion, perceived stress, and experiential avoidance were associated
with aspects of surgeons’ attitudes and beliefs regarding psychosocial care.
Results: After accounting for the influence of relevant covariates, experiential avoidance explained 2.9-
6.6% of the variance (P-values .002 to .031) in all aspects of surgeon attitudes and beliefs regarding
psychosocial care, except for perceived resource availability. Perceived stress and compassion toward
others were not associated with any outcome variable.
Conclusion: Targeting orthopedic surgeons’ tendency to avoid discomfort (i.e., experiential avoidance) via
supportive/educational programs may decrease barriers and increase their abilities to address psychosocial
factors, resulting in improved patient outcomes.
Level of evidence: III