The affect of personality traits and decision-making style on post-operative quality of life and distress in patients undergoing pelvic exenteration.

AIM: To identify whether personality traits and decision-making styles affect quality of life (QoL) outcomes and levels of psychological distress following pelvic exenteration (PE). METHOD: Patients undergoing PE between 2008 and 2015 were identified from a prospectively maintained database at a single quaternary referral centre. Patients were invited to complete two validated questionnaires, with the Big Five Inventory used to assess personality traits and the Melbourne Decision Making Questionnaire used to determine decision-making style. Data on QoL outcomes and distress was utilised from the prospectively established database. QoL with respect to both physical and mental health component was measured using Short Form 36 version 2 (SF-36v2) and the Functional Assessment of Cancer Therapy - Colorectal (FACT-C). Distress was measured using the Distress Thermometer. Post-operative pain scores were also measured using Short Form 36 V2. RESULTS: Of the 93 patients eligible for participation, 42 patients returned the study questionnaire. On multivariate analysis, neuroticism was the most significant predictor of poorer quality of life, and increased levels of distress, consistent across all of the measures utilised and at the different time points used. Other personality traits showed isolated statistically significant impact upon QoL. There were no significant findings with respect to decision-making style. Apart from neuroticism, the most significant predictor of QoL was the number of major complications for the patient. CONCLUSIONS: Patients demonstrating neurotic personality traits show poorer QoL outcomes and higher levels of distress following PE. Identifying these patients would allow targeted pre- and post-operative intervention to improve outcomes following PE.