Effect of Centering Preoperative Counseling on Patient-Reported Anxiety in Patients with Gynecologic Malignancies

Adam Pyrzak, Olivia W. Foley*, Anne K. Grace, Emma L. Barber

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: Centering is a unique form of counseling that unifies education and supporting patients with similar conditions to facilitate learning and develop a mutual support network. This study's primary objective was to evaluate the effect of centering preoperative counseling on anxiety scores in patients with newly diagnosed gynecologic malignancies. Secondary outcomes included the effect of this form of counseling on depression, compliance with preoperative instructions, hospital length of stay, and use of unscheduled health care resources. Materials and Methods: In this prospective cohort study, women with known or suspected gynecologic malignancies were assigned to standard-of-care counseling or centering. The centering cohort participated in a 1-1.5 hour online group-counseling session before surgery. All participants completed Patient-Reported Outcomes Measurement Information System® (PROMIS®) anxiety and depression patient-reported outcome (PRO) surveys at baseline, preoperatively, and 4 weeks postoperatively. Paired and unpaired t-tests were used to evaluate differences in PROs between timepoints and between the cohorts. χ2, Fisher's exact, and Wilcoxon rank-sum tests were used to evaluate secondary outcomes. Results: There were 17 patients in the standard-of-care cohort and 52 patients in the intervention cohort evaluated. The centering group had a reduction of 4.8 points in anxiety scores after the intervention. There was no difference in Enhanced Recovery After Surgery compliance or utilization of unscheduled health care resources between the 2 cohorts. Conclusions: Centering preoperative counseling meaningfully reduces anxiety scores in patients undergoing surgery for suspected gynecologic malignancy.

Original languageEnglish (US)
Pages (from-to)74-81
Number of pages8
JournalJournal of Gynecologic Surgery
Issue number2
StatePublished - Apr 1 2023


  • centering
  • gynecologic cancer
  • mental health
  • patient reported outcomes
  • preoperative counseling
  • quality of life

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology


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