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

J. S. Teunissen; M. J.W. van der Oest; D. E. van Groeninghen; R. Feitz; S. E.R. Hovius; E. P.A. Van der Heijden

doi:10.1186/s12891-022-05045-x

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

J. S. Teunissen^*, M. J.W. van der Oest, D. E. van Groeninghen, R. Feitz, S. E.R. Hovius, E. P.A. Van der Heijden

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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).

Original language	English
Article number	109
Journal	BMC Musculoskeletal Disorders
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12891-022-05045-x
Publication status	Published - 1 Feb 2022

Bibliographical note

Funding Information:
We thank all patients who participated and allowed their data to be anonymously used for the present study. We also thank the Hand Wist Study Group members for their collaboration. The list of members can be found in Additional file 4.

Publisher Copyright:
© 2022, The Author(s).

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The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathologyFinal published version, 1.07 MBLicence: CC BY

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Teunissen, J. S., van der Oest, M. J. W., van Groeninghen, D. E., Feitz, R., Hovius, S. E. R., & Van der Heijden, E. P. A. (2022). The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up. BMC Musculoskeletal Disorders, 23(1), Article 109. https://doi.org/10.1186/s12891-022-05045-x

@article{e094c011a546426d9289695f0a12b63a,

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

abstract = "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{\textquoteright} 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).",

author = "Teunissen, {J. S.} and {van der Oest}, {M. J.W.} and {van Groeninghen}, {D. E.} and R. Feitz and Hovius, {S. E.R.} and {Van der Heijden}, {E. P.A.}",

note = "Funding Information: We thank all patients who participated and allowed their data to be anonymously used for the present study. We also thank the Hand Wist Study Group members for their collaboration. The list of members can be found in Additional file 4. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = feb,

day = "1",

doi = "10.1186/s12891-022-05045-x",

language = "English",

volume = "23",

journal = "BMC Musculoskeletal Disorders",

issn = "1471-2474",

publisher = "BioMed Central Ltd.",

number = "1",

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The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up. / Teunissen, J. S.; van der Oest, M. J.W.; van Groeninghen, D. E. et al.
In: BMC Musculoskeletal Disorders, Vol. 23, No. 1, 109, 01.02.2022.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology

T2 - a cohort study with 1-year follow-up

AU - Teunissen, J. S.

AU - van der Oest, M. J.W.

AU - van Groeninghen, D. E.

AU - Feitz, R.

AU - Hovius, S. E.R.

AU - Van der Heijden, E. P.A.

N1 - Funding Information: We thank all patients who participated and allowed their data to be anonymously used for the present study. We also thank the Hand Wist Study Group members for their collaboration. The list of members can be found in Additional file 4. Publisher Copyright: © 2022, The Author(s).

PY - 2022/2/1

Y1 - 2022/2/1

N2 - 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).

AB - 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).

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U2 - 10.1186/s12891-022-05045-x

DO - 10.1186/s12891-022-05045-x

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AN - SCOPUS:85123974477

SN - 1471-2474

VL - 23

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

IS - 1

M1 - 109

ER -

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

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