Self-Efficacy, Surgical Fear and Psychological Well-Being in Abdominal Surgery

Moderating Effect of Self-Efficacy on the Relationship Between Surgical Fear and Psychological Well-Being in Patients Undergoing Abdominal Surgery Within the Framework of Bandura's Social Cognitive Theory

Surgical fear is a common psychological response among patients undergoing abdominal surgery and may adversely affect psychological well-being during the perioperative period. Individual psychosocial characteristics, particularly self-efficacy, may influence how patients perceive and cope with surgical fear. This cross-sectional observational study aims to determine the moderating effect of self-efficacy on the relationship between surgical fear and psychological well-being in patients undergoing abdominal surgery within the framework of Bandura's Social Cognitive Theory. Data will be collected preoperatively using validated questionnaires from 300 adult patients. The findings are expected to contribute to the identification of patients at risk for poor psychological outcomes and support the development of individualized nursing interventions.

Study Overview

• Status: Active, not recruiting
• Conditions: Nursing Care; Well-Being, Psychological; Surgical Fear and Worrying

Detailed Description

Abdominal surgery is associated with considerable psychological stress before the operation. Patients frequently experience fear related to anesthesia, postoperative pain, surgical complications, uncertainty regarding recovery, and changes in daily functioning. Elevated levels of surgical fear have been associated with poorer psychological outcomes and may negatively affect perioperative adaptation.

Psychological well-being reflects an individual's positive psychological functioning and ability to maintain emotional balance during stressful life events. However, not all patients experiencing surgical fear demonstrate the same level of psychological well-being, suggesting that personal characteristics may influence this relationship.

Bandura's Social Cognitive Theory provides a theoretical framework for understanding these individual differences. According to the theory, self-efficacy refers to an individual's belief in their capability to successfully perform behaviors required to manage challenging situations. Patients with higher self-efficacy are expected to perceive surgical stress as more manageable, use more effective coping strategies, and maintain better psychological well-being despite experiencing surgical fear.

Although previous studies have separately investigated surgical fear, self-efficacy, and psychological well-being, evidence regarding the moderating role of self-efficacy in the relationship between surgical fear and psychological well-being among patients undergoing abdominal surgery is limited.

This single-center analytical cross-sectional study will be conducted in the General Surgery Clinic of Aydın Adnan Menderes University Research and Application Hospital. Adult patients scheduled for abdominal surgery will be recruited consecutively before surgery. Data will be collected using a Patient Information Form, the Surgical Fear Questionnaire, the Psychological Well-Being Scale, and the Self-Efficacy Scale.

The primary objective of the study is to determine whether self-efficacy moderates the relationship between surgical fear and psychological well-being. The results are expected to contribute to theory-based nursing care by improving the identification of patients at risk for poor psychological adaptation and supporting the development of individualized psychosocial interventions.

• Study Type: Observational
• Enrollment (Estimated): 300

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Zafer Mahallesi
    • Aydin, Zafer Mahallesi, Turkey (Türkiye), 09010
      • Aydın Adnan Menderes University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adult patients scheduled to undergo elective abdominal surgery at the General Surgery Clinic of Aydın Adnan Menderes University Research and Application Hospital who meet the eligibility criteria and provide informed consent will be consecutively enrolled in the study.

Description

Inclusion Criteria:

• Adults aged 18 years or older
• Scheduled to undergo elective abdominal surgery
• Able to read, speak, and understand Turkish
• Conscious and able to complete the questionnaires
• Willing to participate and provide informed consent

Exclusion Criteria:

• Diagnosis of dementia
• Visual or hearing impairment preventing questionnaire completion
• Undergoing abdominal surgery due to cancer
• Refusal or withdrawal of participation at any stage of the study

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological Well-Being	The scale consists of a single sub-dimension and 8 items. The items are Likert-type, ranging from 1 (Strongly disagree) to 7 (Strongly agree). The lowest possible score is 8 and the highest is 56. Higher scores on the scale are interpreted as an increase in psychological well-being.	Preoperative assessment (within 24 hours before surgery)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Surgical Fear	The Surgical Fear Scale will be used for assessment. The scale consists of 8 items and is an 11-point Likert-type scale, scored from 0 to 10. Each item is scored from 0, meaning "not afraid at all," to 10, meaning "very afraid." The scale measures fear of the short-term and long-term outcomes of surgery. The minimum possible score is 0, and the maximum is 40. A higher score indicates a high level of surgical fear.	Preoperative assessment (within 24 hours before surgery)
Self-Efficacy	The Self-Efficacy Scale consists of 23 items on a 5-point Likert scale. It is used to measure general self-efficacy perception, not specific to any particular area. It has four sub-dimensions: initiating behavior, maintaining behavior, completing behavior, and overcoming obstacles. The minimum possible score on the scale is 23, and the maximum is 115. A higher score indicates a higher perception of self-efficacy.	Preoperative assessment (within 24 hours before surgery)

Collaborators and Investigators

• Sponsor: Aydin Adnan Menderes University

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2026
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): September 30, 2026

Study Registration Dates

• First Submitted: August 5, 2026
• First Submitted That Met QC Criteria: August 5, 2026
• First Posted (Actual): August 10, 2026

Study Record Updates

• Last Update Posted (Actual): August 12, 2026
• Last Update Submitted That Met QC Criteria: August 8, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Personal Satisfaction; Psychological Well-Being
• Other Study ID Numbers: Surgical Fear and Well-Being

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
• IPD Sharing Time Frame: 12 months after publication
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No