The Use of Psychosocial Services Post Hand and Upper Limb Injury and Trauma: A Pilot Study

Chown, Gregory; Beckwold, Mary; Chernosky, Heather; Lozoskie, Jonathan; Yerkes, Allison

doi:10.1177/1558944717725373

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…Furthermore, pain intensity, catastrophic thinking, and magnitude of disability can be largely explained by psychological factors (Teunis et al, 2015). Unfortunately, psychological factors are often overlooked both in research and in clinical practice within hand therapy (Chown et al, 2018;Hannah 2011;Takata et al, 2019). Participants in our study experiencing stress or anxiousness upon arriving at therapy conveyed how these factors were somewhat reduced by the mind-body interventions, providing impetus for continued investigation of how mind-body interventions can mitigate psychological symptoms.…”

Section: Discussionmentioning

confidence: 82%

Fostering Holistic Hand Therapy: Emergent Themes of Client Experiences of Mind–Body Interventions

Takata

Hardison

Roll

2019

OTJR: Occupational Therapy Journal of Research

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Mind–body interventions are a viable holistic approach to rehabilitation; however, evidence for mind–body approaches in hand therapy is lacking. This study explored the experiences of clients with musculoskeletal disorders undergoing two mind–body interventions within hand therapy. Qualitative data were obtained from clients who received mindfulness meditation and sonographic biofeedback as part of hand therapy. Semi-structured interviews conducted after four therapy sessions elicited participants’ experiences and acceptability. Emergent themes were identified through an iterative, qualitative descriptive process. The following three themes emerged as results: insight on the body, relaxation and relief, and I am in control. A fourth theme was identified in the acceptability data, that is, mindfulness as a meaningful activity. At least one of the interventions was acceptable to each participant. Positive participant experiences support further consideration of mind–body interventions as a useful holistic approach in hand therapy to support wellness, quality of care, and participation in recovery.

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Section: Discussionmentioning

confidence: 82%

Fostering Holistic Hand Therapy: Emergent Themes of Client Experiences of Mind–Body Interventions

Takata

Hardison

Roll

2019

OTJR: Occupational Therapy Journal of Research

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“…Many previous investigators have called for mental health screening and psychosocial services to be part of standard care for this patient population [ 9 , 13 , 16 , 20 , 21 , 23 , 35 , 36 ], but recent research suggests that such screening or services are not common amongst any hand trauma services [ 37 ]. Our study brings new knowledge to this field providing strong support for new models of care which recognize the associated mental health challenges.…”

Section: Discussionmentioning

confidence: 99%

Comparison of short-term outcomes between people with and without a pre-morbid mental health diagnosis following surgery for traumatic hand injury: a prospective longitudinal study of a multicultural cohort

Naylor,

Bhandari,

Descallar

et al. 2023

BMC Musculoskelet Disord

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Background Following traumatic hand injury, few studies have compared outcomes between people with and without a pre-morbid mental health diagnosis. This study aimed to compare sub-acute outcomes in a multicultural patient cohort with surgically managed traumatic hand injury with and without a pre-morbid mental health diagnosis. Methods A prospective, observational cohort study of people with traumatic hand injury presenting pre- surgically to a high-volume hand injury centre in a region of cultural and language diversity was conducted. Participants were assessed face-to-face (baseline) then via telephone (3-months post-surgery) and categorized according to a pre-morbid medically diagnosed mental health diagnosis. Baseline and follow-up assessments included global mental health, and the EuroQol (EQ) ‘Health Today’ analogue scale (0–100) and health domains. Return-to-work status, complications/symptomatic complaints, and hand function (QuickDASH) were also collected at follow-up. Adjusted analyses—accounting for covariates including cultural identity—were conducted to determine whether 3-month outcomes were associated with a pre-morbid mental health diagnosis. Results From 405 eligible patients, 386 were enrolled (76% male, mean age 38.9 (standard deviation 15.6)); 57% self-identified as Australian and 22% had a pre-morbid mental health diagnosis. Common injuries regardless of pre-morbid mental health diagnosis were skin (40%), tendon (17%) and bone (17%) injuries. None were complex mutilating injuries. Seventy-eight per cent of the cohort was followed-up. In adjusted analyses, a pre-morbid mental health diagnosis was associated with lower odds for reporting ‘good or better’ global mental health (Odds Ratio (OR) 0.23 (95% Confidence Interval (CI) 0.18, 0.47), p < 0.001), ‘no’ anxiety or depression (OR 0.21 (0.11, 0.40), p < 0.001) and no pain (OR 0.56 (0.31, 0.98), p = 0.04)(EQ domains), and worse EQ ‘Health Today’ (10 points on average (95%CI -14.9, -5.1, p < 0.001). QuickDASH scores, rates of complications/symptomatic complaints and return-to-work profiles were similar. Conclusions Despite reporting worse mental and health-related quality-of-life outcomes post-surgery, people with a pre-morbid mental health diagnosis regardless of cultural identity experienced similar clinical and return-to-work outcomes. Future research assessing the value of screening for pre-morbid mental health conditions on post-surgical outcomes is required and should include people with more complex hand injuries.

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“…Although effective interventions for psychological disorders are available they are not widely used for hand patients. Chown et al (2018) surveyed occupational therapists and hand therapist and identified a lack of psychosocial assessments, interventions and referral services following hand and upper limb injury and trauma. They concluded that psychosocial factors are not typically being addressed during the rehabilitation process.…”

Section: Discussionmentioning

confidence: 99%

“…The theory is that the brain will then reprocess the thoughts without the previously associated negative emotions. These treatments are not widely available to patients with hand disorders and psychological symptoms with management focusing on the physical hand problem (Chown et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of cognitive behavioural therapy for patients with concurrent hand and psychological disorders

Lucas¹,

Burke²,

Selby³

et al. 2022

J Hand Surg Eur Vol

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We investigated the effectiveness of cognitive behavioural therapy (CBT) for patients with psychological disorders thought to be influencing recovery from elective and traumatic hand conditions. Demographic data and psychological assessment scores (Primary Health Questionnaire 9 (PHQ9), General Anxiety Disorder Assessment (GAD7), Impact of Event Scale (IES)) were prospectively collected before and after CBT treatment. One hundred and fourteen patients underwent CBT with 81 completing treatment. Full data was available for 78 (68%) patients. Mean age was 43 (range 13–84) and 63% were women. Sixty-one per cent had sustained a traumatic hand injury. PHQ9, GAD7 and IES scores decreased significantly following treatment. Many patients with hand conditions have associated psychological problems that may influence outcome. CBT in a hand unit setting appears to be an effective treatment. Further research with a control group should investigate whether CBT improves psychological health or if this may occur as patients recover from their physical hand disorder regardless of CBT. Level of evidence: IV

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The Use of Psychosocial Services Post Hand and Upper Limb Injury and Trauma: A Pilot Study

Cited by 8 publications

References 27 publications

Fostering Holistic Hand Therapy: Emergent Themes of Client Experiences of Mind–Body Interventions

Fostering Holistic Hand Therapy: Emergent Themes of Client Experiences of Mind–Body Interventions

Comparison of short-term outcomes between people with and without a pre-morbid mental health diagnosis following surgery for traumatic hand injury: a prospective longitudinal study of a multicultural cohort

The effectiveness of cognitive behavioural therapy for patients with concurrent hand and psychological disorders

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