Jafar Bakhshaie - Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
James Doorley - Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Mira Reichman - Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Tom Crijns - Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
Kristin Archer - Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
Stephen Wegener - Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
Renan Castillo - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
David Ring - Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
Ana-Maria Vranceanu - Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, 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 andsocial aspects of illness. A better understanding of these factors could help inform interventions to supportsurgeons and improve patient outcomes. We aimed to investigate whether orthopedic surgeons’ self-reportedcompassion, perceived stress, and experiential avoidance are independently associated with various surgeonattitudes and beliefs regarding psychosocial aspects of health.Methods: This is a cross-sectional study of ۱۶۵ members of the Science of Variation Group (SOVG).Surgeons completed measures of compassion, stress, experiential avoidance, and demographics. Theyanswered questions addressing attitudes and beliefs regarding psychosocial aspects of care, which werecondensed to the following ۶ dimensions through factor analysis: (۱) confidence, (۲) perceived resourceavailability, (۳) blame towards patients, (۴) fear of offending patients, (۵) professional role resistance, and(۶) fear of negative patient reactions. We performed ۶ multivariable hierarchical regression analyses todetermine whether self-reported compassion, perceived stress, and experiential avoidance were associatedwith aspects of surgeons’ attitudes and beliefs regarding psychosocial care.Results: After accounting for the influence of relevant covariates, experiential avoidance explained ۲.۹-۶.۶% of the variance (P-values .۰۰۲ to .۰۳۱) in all aspects of surgeon attitudes and beliefs regardingpsychosocial care, except for perceived resource availability. Perceived stress and compassion towardothers were not associated with any outcome variable.Conclusion: Targeting orthopedic surgeons’ tendency to avoid discomfort (i.e., experiential avoidance) viasupportive/educational programs may decrease barriers and increase their abilities to address psychosocialfactors, resulting in improved patient outcomes.Level of evidence: III

Experiential avoidance, Mental health, Psychosocial, surgeons’ attitudes