The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

Ayers, David C.; Franklin, Patricia D.; Ring, David

doi:10.2106/jbjs.l.00799

Cited by 179 publications

(130 citation statements)

References 69 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…There is also good evidence from orthopaedic populations that poor mental health negatively impacts key physical outcomes following surgery, including pain severity and physical functioning. [12][13][14] . Prolonged work absence incurs considerable personal and societal costs and is another important rehabilitation outcome following surgery [15] .…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Mental disorder in limb reconstruction: Prevalence, associations and impact on work disability

Rayner

Simpson

Matcham

et al. 2016

Journal of Psychosomatic Research

View full text Add to dashboard Cite

Objective: This cross-sectional survey aimed to assess the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), and drug and alcohol dependence in a limb reconstruction population and examine associations with demographic and functional variables.Methods: As part of routine clinical care, data were collected from 566 patients attending a tertiary referral centre for limb reconstruction between April 2012 and February 2016.Depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol and drug dependence were measured using standardised self-report screening tools.Results: 173 patients (30.6% CI 26.7-34.4) screened positive for at least one of the mental disorders assessed. 110 (19.4% CI 16.2-22.7) met criteria for probable major depression; 112 (19.9% CI 16.6-23.2) patients met criteria for probable generalised anxiety disorder; and 41 (7.6% CI 5.3-9.8) patients met criteria for probable PTSD. The prevalence of probable alcohol dependence and probable drug dependence was 1.6% (CI 0.6-2.7) and 4.5% (CI 2.7-6.3), respectively. Patients who screened positive for depression, anxiety and PTSD reported significantly higher levels of pain, fatigue, and functional impairment. Depression and anxiety were independently associated with work disability after adjustment for covariates (OR 1.98 (CI 1.08-3.62) and OR 1.83 (CI 1.04-3.23), respectively).Conclusion: The high prevalence and adverse associations of probable mental disorder in limb reconstruction attest to the need for routine psychological assessment and support.Integrated screening and management of mental disorder in this population may have a positive impact on patients" emotional, physical and occupational rehabilitation. A randomised controlled trial is needed to test this hypothesis.

show abstract

Section: Accepted M Manuscriptmentioning

confidence: 99%

Mental disorder in limb reconstruction: Prevalence, associations and impact on work disability

Rayner

Simpson

Matcham

et al. 2016

Journal of Psychosomatic Research

View full text Add to dashboard Cite

show abstract

“…Кроме того, авторы показали, что такие отклонения психического состояния, как повышенная тревожность, депрессия, наруше-ние сна, катастрофизация боли, чрезмерная на-стороженность и субъективно воспринимаемая несправедливость, также оказывают влияние на формирование высокого уровня болевого син-дрома после операции [1,2,13,23,36].…”

unclassified

“…Lindberg 3,4 , C. Gay 3,5 , L.A. Rosseland 4,6 , A. Lerdal 3,4 , N.N. kornilov 1,2 , T.A. kulyaba демографических, когнитивных, клинических и хирургических факторов с интенсивностью и динамикой болевого синдрома в раннем по-слеоперационном периоде после тотального эндопротезирования коленного сустава.…”

unclassified

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Сараев

Lindberg

Гэй

et al. 2017

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Purpose – to describe the relationship of selected socio-demographic, clinical, and surgical factors with the severity and patterns of postoperative pain during the first three days following total knee arthroplasty.Material and methods. The sample included 100 patients (93 women and 7 men; mean age 63.5±7.8 years) with osteoarthritis admitted for primary total knee arthroplasty. Prior to surgery, standard measures were used to assess preoperative pain and other symptoms, clinical manifestations of osteoarthritis, functional status of the knee, comorbidities, functional abilities, quality of life, and other patient characteristics. Physical, biochemical and surgical parameters of the perioperative period were also recorded. Patterns of daily changes in postoperative pain characteristics were investigated with the use of individual diaries. Results. All the analyzed indicators of postoperative pain progressively decreased during the three days after surgery (р0,001), including the number of daily hours of moderate to severe pain (р0,001). Pain levels were generally higher among women than among men (р = 0,009). Of the analyzed preoperative factors, higher levels postoperative pain were correlated with higher levels of anxiety (р = 0,029) and preoperative pain intensity (р = 0,029). Among the perioperative factors, surgery duration longer than 90 minutes was associated with higher levels of postoperative pain in activity (р = 0,012) and more hours of moderate/severe pain (р = 0,008). Characteristics of postoperative pain were unrelated to level of patient education, social or family status, employment, lifestyle, or any other clinical or laboratory variables.Conclusion. Of the many factors previously associated with postoperative pain, only gender, anxiety and level of preoperative pain confirmed their importance in this study. Among the perioperative factors, surgery duration, which varied by the type of implant, was significantly associated with postoperative pain levels.

show abstract

“…T he aspects of illness unrelated to pathophysiology have long been the ''elephant in the room'' [1]. Orthopaedic surgeons are accustomed to patients asking to be ''fixed'' as if they were a broken machine.…”

mentioning

confidence: 99%

“…George Engel and John Romano [2]. Their biopsychosocial model of illness is utilized to evaluate a patient with a musculoskeletal symptom [1]. Musculoskeletal illness is biological (arthritis, fracture), psychological (stress, distress), and sociological (family, work, disputes).…”

mentioning

confidence: 99%

Editorial Comment: Symposium: Psychosocial Aspects of Musculoskeletal Illness

Ring¹,

Ayers

2015

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

The Role of Emotional Health in Functional Outcomes After Orthopaedic Surgery: Extending the Biopsychosocial Model to Orthopaedics

Cited by 179 publications

References 69 publications

Mental disorder in limb reconstruction: Prevalence, associations and impact on work disability

Mental disorder in limb reconstruction: Prevalence, associations and impact on work disability

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Editorial Comment: Symposium: Psychosocial Aspects of Musculoskeletal Illness

Contact Info

Product

Resources

About