Patient's personality predicts recovery after total knee arthroplasty: a retrospective study
Tóm tắt
Increasing attention to psychological determinants may be useful in identifying patients undergoing total knee arthroplasty who may be at risk for poor postoperative outcome. However, little is known about the relationship between personality as a comprehensive reflection of stable psychological states and outcome after total knee arthroplasty. The purpose of this study was to describe the relationship between patients’ diverse personalities and clinical outcomes. We recruited 387 patients undergoing primary total knee arthroplasty to complete the Eysenck Personality Questionnaire (EPQ) and collected demographic information before surgery. Prior to and 6 months after surgery, we used two validated functional instruments to assess satisfaction rate—the Short Form Health Survey of 36 questions (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Neuroticism, especially the classic type, tended to be displayed more frequently by women and younger patients. A statistically significant positive relationship was seen between outcome scores and extraversion levels in rating scales; there was a negative relationship between outcome scores especially from the SF-36 Mental Component Summary (MCS), WOMAC pain scores, and neuroticism subscales scores. Among four types of personality, sanguine patients displayed the best clinical outcomes and melancholic patients the worst. Despite good clinical outcomes, including in pain relief and functional improvement for choleric patients, satisfaction rate was unexpectedly the lowest. Our results may help clinicians identify patients at risk for poor postoperative clinical outcomes and thus proceed with better communication with patients. Also, our results may indicate conducting individual attention during the perioperative period based on patient personality determined according to the EPQ in order to help attain better recovery.
Tài liệu tham khảo
Rasanne P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynanen OP. Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs. Acta Orthop. 2007;78:108–15.
Wylde V, Dieppe P, Hewlett S, Learmonth ID. Total knee replacement: is it really an effective procedure for all? Knee. 2007;14:417–23.
Vissers MM, Bussmann JB, Verhaar JA, Busschbach JJ, Bierma-Zeinstra SM, Reijman M. Psychological factors affecting the outcome of total hip and knee arthroplasty: a systematic review. Semin Arthritis Rheum. 2012;41:576–88.
Edwards RR, Haythornthwaite JA, Smith MT, Klick B, Katz JN. Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement. Pain Res Manag. 2009;14:307–11.
Brander VA, Stulberg SD, Adams AD, Harden RN, Bruehl S, Stanos SP. Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res 2003;(416): 27–36.
Forsythe ME, Dunbar MJ, Hennigar AW, Sullivan MJ, Gross M. Prospective relation between catastrophizing and residual pain. Following knee arthroplasty: two-year follow-up. Pain Res Manag. 2008;13:335–41.
Riddle DL, Wade JB, Jiranek WA, Kong X. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clin Orthop Relat Res. 2010;468:798–806.
Badura-Brzoza K, Zajac P, Kasperska-Zajac A. Psychological and psychiatric factors related to quality of life after total hip replacement: preliminary report. Eur Psychiatry. 2009;24:119–24.
Lingard EA, Riddle DL. Impact of psychological distress on pain and function following knee arthroplasty. J Bone Joint Surg Am. 2007;89:1161–9.
Salmon P, Hall GM, Peerbhoy D. Influence of the emotional response to surgery on functional recovery during 6 months after hip arthroplasty. J Behav Med. 2001;24:489–502.
Riediger W, Doering S, Krismer M. Depression and somatisation influence the outcome of total hip replacement. Int Orthop. 2010;34:13–8.
Sullivan M, Tanzer M, Stanish W, Fallaha M, Keefe FJ, Simmonds M. Psychological determinants of problematic out comes following total knee arthroplasty. Pain. 2009;143:123–9.
Engel C, Hamilton NA, Potter PT, Zautra AJ. Impact of two types of expectancy on recovery from total knee replacement surgery (TKR) in adults with osteoarthritis. Behav Med. 2004;30:113–23.
Mannion AF, Kampfen S, Munzinger U, Kramers-de Quervain I. The role of patient expectations in predicting outcome after total knee arthroplasty. Arthritis Res Ther. 2009;11:R139.
Mahomed NN, Liang MH, Cook EF, Daltroy LH, Fortin PR, Fossel AH. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002;29:1273–9.
Sullivan MJL, Rodgers WM, Kirsch I. Catastrophizing, depression and expectancies for pain and emotional distress. Pain. 2001;91:147–54.
Banks SR, Kerns RD. Explaining high rates of depression in chronic pain. A diathesis-stress hypothesis. Psychol Bull. 1996;119:95–110.
Kreder HJ, Grasso P, Williams JI. Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario. Can J Surg. 2003;46:15–22.
Morrison RS, Magaziner J, McLaughlin MA. The impact of post-operative pain on outcomes following hip fracture. Pain. 2003;103:303–11.
Sullivan MJL, Rodgers WM, Kirsch I. Catastrophizing, depression and expectancies for pain and emotional distress. Pain. 2001;91:147–54.
Roth ML, Tripp DA, Harrison MH, Sullivan M, Carson P. Demographic and psychosocial predictors of acute perioperative pain for total knee arthroplasty. Pain Res Manag. 2007;12:185–194.
Edwards RR, Bingham CO III, Bathon J, Haythornthwaite JA. Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Rheum. 2006;55:325–32.
Sullivan MJ, Thorn B, Haythornthwaite JA. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17:52–64.
Vissers MM, Bussmann JB, Verhaar JA, Busschbach JJ, Bierma-Zeinstra SM, Reijman M. Psychological factors affecting the outcome of total hip and knee arthroplasty: a systematic review. Semin Arthritis Rheum. 2012;41:576–88.
Eysenck HJ. The biological basis of personality. Springfield: Thomas; 1967.
Upmanyu VV, Bhardwaj S, Singh S. Word-association emotional indicators: associations with anxiety, psychoticism, neuroticism, extraversion, and creativity. J Soc Psychol. 1996;136(4):521–9.
Eysenck HJ, Eysenck SBG (1991) Manual of the Eysenck Personality Scales, Hodder & Stoughton, London, 1991.31.C.
Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35:424–36.
Aarons H, Hall G, Hughes S, Salmon P. Short-term recovery from hip and knee arthroplasty. J Bone Joint Surg Br. 1996;78:555–8.