The importance of perceived helplessness and emotional health in understanding the relationship among pain, function, and satisfaction following revision knee replacement surgery

被引：23

作者：

Venkataramanan, V. ^{[1
]}

Gignac, M. A. ^{[1
,2
]}

Dunbar, M. ^{[3
,4
]}

Garbuz, D. ^{[5
]}

Gollish, J. ^{[6
]}

Gross, A. ^{[7
]}

Hedden, D. ^{[8
,9
]}

MacDonald, S. J. ^{[10
]}

Mahomed, N. N. ^{[11
]}

Schemitsch, E. ^{[12
]}

Davis, A. M. ^{[1
,13
,14
,15
]}

机构：

[1] Univ Hlth Network, Toronto Western Res Inst, Div Hlth Care & Outcomes Res, Toronto, ON M5T 2S8, Canada

[2] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[3] Dalhousie Univ, Dept Surg, Halifax, NS B3H 4H2, Canada

[4] Queen Elizabeth 2 Hlth Sci Ctr, Div Orthopaed, Halifax, NS, Canada

[5] Univ British Columbia, Dept Orthopaed, Vancouver, BC V5Z 1M9, Canada

[6] Sunnybrook Hlth Sci Ctr, Holland Orthopaed & Arthrit Ctr, Div Orthopaed, Toronto, ON M4N 3M5, Canada

[7] Mt Sinai Hosp, Div Orthopaed, Toronto, ON M5G 1X5, Canada

[8] Concordia Hip & Knee Inst, Winnipeg, MB, Canada

[9] Univ Manitoba, Winnipeg, MB, Canada

[10] Univ Western Ontario, London Hlth Sci Ctr, Div Orthopaed Surg, London, ON, Canada

[11] Univ Hlth Network, Toronto Western Res Inst, Div Orthopaed Surg, Toronto, ON M5T 2S8, Canada

[12] St Michaels Hosp, Div Orthopaed Surg, Toronto, ON M5B 1W8, Canada

[13] Univ Toronto, Dept Phys Therapy, Toronto, ON, Canada

[14] Univ Toronto, Dept Rehabil Sci, Toronto, ON, Canada

[15] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

来源：

OSTEOARTHRITIS AND CARTILAGE | 2013年 / 21卷 / 07期

基金：

加拿大健康研究院;

关键词：

Revision knee replacement; Satisfaction; Pain; Function; Psychological factors; Mediation; PATIENT SATISFACTION; OLDER-ADULTS; RHEUMATOID-ARTHRITIS; OUTCOMES; ARTHROPLASTY; DEPRESSION; EXPECTATIONS; MODERATE; DISEASE;

D O I：

10.1016/j.joca.2013.04.005

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

Objective: Little is known about the relationships among pain, function, psychological variables like perceived helplessness and emotional health, and patient satisfaction in people with revision knee replacement surgery. We hypothesized that pain and function would have a direct association with satisfaction as well as an indirect association through patient perceptions of helplessness and emotional health. Design: This longitudinal study included 145 participants undergoing revision knee replacement surgery. Demographic data and expectation of benefit from surgery were recorded prior to surgery. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Arthritis Helplessness Scale (AHS) and the Mental Component Scale (MCS) of the SF-36 (emotional health) were collected prior to and 2 years post-surgery. Satisfaction was recorded 2 years post-surgery. Regression analyses were conducted to test for mediation effects of helplessness and MCS. Results: Participants were on average 69 years old and 54% were women. Participants were satisfied with the results of the surgery (mean standard deviation (SD) = 70.42 +/- 31.46). Less pain and functional disability were associated with increased patient satisfaction and, the effect of pain or function was also mediated through helplessness whereby more pain and disability were associated with perceptions of helplessness and helplessness was associated with lower satisfaction. MCS did not mediate the relationship of pain and function with satisfaction. Conclusion: Helplessness plays an important role in understanding patient satisfaction. Interventions aimed at improving patient outcome should target not only pain and function but also should address strategies to support people in managing following knee revision surgery to maximize satisfaction with outcome. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

引用

页码：911 / 917

页数：7

共 59 条

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Functional outcome and patient satisfaction in total knee patients over the age of 75 [J].