Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

Blackburn, Julia; Oest, Mark J. W. van der; Chen, Neal C.; Feitz, Reinier; Duraku, Liron S.; Zuidam, J. Michiel; Vranceanu, Ana‐Maria; Selles, Ruud W.

doi:10.1097/corr.0000000000001577

Cited by 17 publications

(23 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to pain catastrophising, higher treatment expectations were independently associated with a better 1-year outcome. This is in line with a previous study on the surgical outcome of Quervain’s disease [ 33 ]. Interestingly, the mean improvement during the first year after surgery -although with a higher level of pain and dysfunction at intake- did not seem to differ based on pain catastrophising or anxiety and depression.…”

Section: Discussionsupporting

confidence: 93%

“…Similar to other studies, PCS and PHQ scores were added simultaneously but separately from B-IPQ since pain catastrophising and psychological distress have been studied more extensively [ 10 , 12 , 13 ]. Outcome expectations were only evaluated in the outcome models (model 2) [ 33 ]. The variable treatment was added in the models as an instrumental variable for diagnosis/pathology.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up

Teunissen¹,

Oest

Groeninghen³

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Aims Ulnar-sided wrist pain has historically been equated to lower-back pain of wrist surgery. Little is known about the relationship between psychosocial profile and the manifestation of ulnar-sided wrist pathology and their treatment outcomes. This study aimed to determine the impact of pain catastrophising, psychological distress, illness perception, and patients’ outcome expectations on patient-reported pain and hand function before and one year after surgery for ulnar-sided wrist pathology. Patients and Methods We included patients who underwent surgical treatment for ulnar-sided wrist pathology. Before surgery, patients completed the Pain Catastrophising Scale (PCS), Patient Health Questionnaire (PHQ), Brief-Illness Perception Questionnaire (B-IPQ), and Credibility/Expectancy Questionnaire (CEQ). Pain and dysfunction were assessed before (n = 423) and one year after surgery (n = 253) using the Patient Rated Wrist/Hand Evaluation (PRWHE). Hierarchical linear regression was used to assess the relationship between psychosocial factors and the preoperative PRWHE score, postoperative PRWHE score, and change in PRWHE. Results Psychosocial variables explained an additional 35% of the variance in preoperative PRWHE scores and 18% on postoperative scores. A more negative psychosocial profile was associated with higher (worse) preoperative PRWHE scores (PCS: B = 0.19, CI = [0.02–0.36]; B-IPQ Consequences: B = 3.26, CI = 2.36–4.15; and B-IPQ Identity, B = 1.88 [1.09–2.67]) and postoperative PRWHE scores (PCS: B = 0.44, CI = [0.08–0.81]) but not with the change in PRWHE after surgery. Higher treatment expectations were associated with a lower (better) postoperative PRWHE score (CEQ expectancy: B = -1.63, CI = [-2.43;-0.83]) and a larger change in PRWHE scores (B =|1.62|, CI = [|0.77; 2.47|]). Conclusion A more negative psychosocial profile was associated with higher pain levels and dysfunction preoperatively and postoperatively. However, these patients showed similar improvement as patients with a more feasible psychosocial profile. Therefore, patients should not be withheld from surgical treatment based on their preoperative psychosocial profile alone. Boosting treatment expectations might further improve treatment outcomes. Level of evidence III (Cohort study).

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up

Teunissen¹,

Oest

Groeninghen³

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…It would therefore be interesting to examine to what extent the clinical staging of the disease contributes to postoperative outcomes and to compare these results with outcomes following conservative management. Furthermore, investigators have also demonstrated that treatment expectations and psychological factors play an important role in postoperative outcomes following surgical decompression of carpal tunnel syndrome (Sun et al., 2021) and De Quervain tenosynovitis (Blackburn et al., 2021). Future studies may examine other factors contributing to postoperative pain and hand function.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with self-reported pain and hand function following surgical A1 pulley release

Koopman

Hundepool

Wouters

et al. 2022

J Hand Surg Eur Vol

Self Cite

View full text Add to dashboard Cite

Surgical A1 pulley release can considerably reduce pain and improve hand function, but individual outcomes are highly variable. This study aimed to identify factors contributing to self-reported pain and hand function 3 months postoperatively. We included 2681 patients who had received surgical treatment for a trigger finger or thumb and who completed the Michigan Hand outcomes Questionnaire (MHQ). Hierarchical linear regression models were used to investigate patient and clinical characteristics associated with postoperative pain and hand function. For both pain and hand function, the most influential factors associated with worse outcomes were worse MHQ scores at baseline (β 0.38 and 0.33, respectively) and ≥3 preoperative steroid injections (β –0.36 and –0.35). These factors indicated that patients with severe preoperative symptoms represent a group with a more advanced disease that is more difficult to treat. These findings can assist clinicians in patient counselling, expectation management and decision-making about the timing of the intervention. Level of evidence: II

show abstract

“…However, another factor that could possibly contribute to this difference is treatment expectation, as prior studies found that a higher treatment expectation is associated with better outcomes following carpal tunnel release 40 and surgical decompression of de Quervain tenosynovitis. 41 Because we were primarily interested in the change in functional outcomes in a representative sample of patients undergoing trigger finger release, we did not adjust for covariates in this study. Future studies should investigate factors contributing to this variability in outcomes.…”

Section: Ementioning

confidence: 99%

Complications and Functional Outcomes following Trigger Finger Release: a Prospective Cohort Study of 1879 Patients

Koopman

Hundepool

Duraku

et al. 2022

Plastic &Amp; Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

Background: Although trigger finger release is considered a safe procedure, large cohort studies reporting consistent complication rates and functional outcomes are scarce. Further insight into outcomes of this commonly performed procedure is essential for adequate treatment evaluation and patient counseling. Therefore, the aim of this study was to assess the complication rates and functional outcomes following trigger finger release. Methods: This is an observational multicenter cohort study of patients undergoing trigger finger release. The primary outcome included the occurrence of complications. The secondary outcome was change in hand function (Michigan Hand outcomes Questionnaire) from baseline to 3 months postoperatively. Results: Complications were observed in 17.1 percent of 1879 patients. Most complications were minor, requiring hand therapy or analgesics (7.0 percent of all patients), antibiotics, or steroid injections (7.8 percent). However, 2.1 percent required surgical treatment and 0.2 percent developed complex regional pain syndrome. The Michigan Hand Outcomes Questionnaire total score improved from baseline to 3 months postoperatively with 12.7 points, although the authors found considerable variation in outcomes with less improvement in patients with better baseline scores. Conclusions: This study demonstrates that trigger finger release results in improved hand function, although complications occur in 17 percent. Most complications are minor and can be treated with nonsurgical therapy, resulting in improved hand function as well. However, additional surgical treatment is required in 2 percent of patients. In addition, the authors found that change in hand function depends on the baseline score, with less improvement in patients with better baseline scores. Future studies should investigate factors that contribute to the variability in treatment outcomes following trigger finger release. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

show abstract

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

Cited by 17 publications

References 30 publications

The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up

The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up

Factors associated with self-reported pain and hand function following surgical A1 pulley release

Complications and Functional Outcomes following Trigger Finger Release: a Prospective Cohort Study of 1879 Patients

Contact Info

Product

Resources

About