The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

M. C. Jansen; Mark J.W. van der Oest; Nicoline P.  de Haas; Ruud W. Selles, PhD; J. Michiel Zuidam, MD, PhD; the Hand-Wrist Study Group

doi:10.1016/j.jhsa.2021.04.002

The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

M. C. Jansen^*, Mark J.W. van der Oest, Nicoline P. de Haas, Ruud W. Selles, PhD, J. Michiel Zuidam, MD, PhD, the Hand-Wrist Study Group

^*Corresponding author for this work

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

4 Citations (Scopus)

Abstract

Purpose: Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery. Methods: Patients who planned to undergo a CTR were asked to fill out the Brief Illness Perception Questionnaire and the Patient Health Questionnaire before surgery to measure their illness perceptions and mental health status, respectively. Return to work was defined as the time until returning to work for 50% of normal hours and was measured using a questionnaire at 6 weeks, 3 months, and 6 months. To identify associations between nonpsychological and psychological patient factors and the return to work after CTR surgery, a Cox proportional hazards model was constructed. Results: In total, 615 patients were included in our study. Six months after surgery, 91% of the patients returned to work. For the psychological patient factors, we found that increases of 1 point on the items of worrying about carpal tunnel syndrome and having faith preoperatively in a beneficial effect of the CTR surgery were associated with hazard ratios of 0.92 (95% confidence interval, 0.88–0.96) and 1.10 (95% confidence interval, 1.02–1.19), respectively, for returning to work in the first 6 months after surgery. An increase of 1 point on the depression subscale of the Patient Health Questionnaire was associated with a hazard ratio of 0.88 (95% confidence interval, 0.78–0.99) for returning to work in the first 6 months after surgery. Conclusions: Our study showed that multiple psychological patient factors are associated with return to work after a CTR surgery. Addressing these psychological factors before surgery might be a low-cost intervention to improve return to work after the CTR surgery. Type of study/level of evidence: Prognostic II.

Original language	English
Pages (from-to)	748-757
Number of pages	10
Journal	Journal of Hand Surgery
Volume	46
Issue number	9
DOIs	https://doi.org/10.1016/j.jhsa.2021.04.002
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
We thank the patients and physicians who participated in this study.

Publisher Copyright:
© 2021 American Society for Surgery of the Hand

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@article{77860debf5ed45d98a05ae449f73b0e6,

title = "The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery",

abstract = "Purpose: Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery. Methods: Patients who planned to undergo a CTR were asked to fill out the Brief Illness Perception Questionnaire and the Patient Health Questionnaire before surgery to measure their illness perceptions and mental health status, respectively. Return to work was defined as the time until returning to work for 50% of normal hours and was measured using a questionnaire at 6 weeks, 3 months, and 6 months. To identify associations between nonpsychological and psychological patient factors and the return to work after CTR surgery, a Cox proportional hazards model was constructed. Results: In total, 615 patients were included in our study. Six months after surgery, 91% of the patients returned to work. For the psychological patient factors, we found that increases of 1 point on the items of worrying about carpal tunnel syndrome and having faith preoperatively in a beneficial effect of the CTR surgery were associated with hazard ratios of 0.92 (95% confidence interval, 0.88–0.96) and 1.10 (95% confidence interval, 1.02–1.19), respectively, for returning to work in the first 6 months after surgery. An increase of 1 point on the depression subscale of the Patient Health Questionnaire was associated with a hazard ratio of 0.88 (95% confidence interval, 0.78–0.99) for returning to work in the first 6 months after surgery. Conclusions: Our study showed that multiple psychological patient factors are associated with return to work after a CTR surgery. Addressing these psychological factors before surgery might be a low-cost intervention to improve return to work after the CTR surgery. Type of study/level of evidence: Prognostic II.",

author = "Jansen, {M. C.} and {van der Oest}, {Mark J.W.} and {de Haas}, {Nicoline P.} and {Selles, PhD}, {Ruud W.} and {Zuidam, MD, PhD}, {J. Michiel} and {the Hand-Wrist Study Group} and Blomme, {R. A.M.} and Sluijter, {B. J.R.} and {van der Avoort}, {D. J.J.C.} and A. Kroeze and J. Smit and J. Debeij and Walbeehm, {E. T.} and {van Couwelaar}, {G. M.} and Vermeulen, {Guus M.} and {de Schipper}, {J. P.} and Temming, {J. F.M.} and {van Uchelen}, {J. H.} and {de Boer}, {H. L.} and {de Haas}, {K. P.} and K. Harmsen and Z{\"o}phel, {O. T.} and R. Feitz and Souer, {J. S.} and {R koch}, koch and Hovius, {S. E.R.} and Moojen, {T. M.} and X. Smit and {van Huis}, R. and Pennehouat, {P. Y.} and K. Schoneveld and {van Kooij}, {Y. E.} and Wouters, {R. M.} and P. Zagt and {van Ewijk}, {F. J.} and Veltkamp, {J. J.} and {de Ridder}, {W. A.} and Slijper, {H. P.} and Selles, {R. W.} and Porsius, {J. T.} and J. Tsehaie and R. Poelstra and Jansen, {M. C.} and {van der Oest}, {Mark J.W.} and Sun, {P. O.} and Schrier, {V. J.M.M.} and L. Hoogendam and Teunissen, {J. S.} and Stege, {M. ter} and Duraku, {L. S.} and Halbesma, {G. J.}",

note = "Funding Information: We thank the patients and physicians who participated in this study. Publisher Copyright: {\textcopyright} 2021 American Society for Surgery of the Hand",

year = "2021",

month = sep,

day = "1",

doi = "10.1016/j.jhsa.2021.04.002",

language = "English",

volume = "46",

pages = "748--757",

journal = "Journal of Hand Surgery",

issn = "0363-5023",

number = "9",

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TY - JOUR

T1 - The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

AU - Jansen, M. C.

AU - van der Oest, Mark J.W.

AU - de Haas, Nicoline P.

AU - Selles, PhD, Ruud W.

AU - Zuidam, MD, PhD, J. Michiel

AU - the Hand-Wrist Study Group

AU - Blomme, R. A.M.

AU - Sluijter, B. J.R.

AU - van der Avoort, D. J.J.C.

AU - Kroeze, A.

AU - Smit, J.

AU - Debeij, J.

AU - Walbeehm, E. T.

AU - van Couwelaar, G. M.

AU - Vermeulen, Guus M.

AU - de Schipper, J. P.

AU - Temming, J. F.M.

AU - van Uchelen, J. H.

AU - de Boer, H. L.

AU - de Haas, K. P.

AU - Harmsen, K.

AU - Zöphel, O. T.

AU - Feitz, R.

AU - Souer, J. S.

AU - R koch, koch

AU - Hovius, S. E.R.

AU - Moojen, T. M.

AU - Smit, X.

AU - van Huis, R.

AU - Pennehouat, P. Y.

AU - Schoneveld, K.

AU - van Kooij, Y. E.

AU - Wouters, R. M.

AU - Zagt, P.

AU - van Ewijk, F. J.

AU - Veltkamp, J. J.

AU - de Ridder, W. A.

AU - Slijper, H. P.

AU - Selles, R. W.

AU - Porsius, J. T.

AU - Tsehaie, J.

AU - Poelstra, R.

AU - Jansen, M. C.

AU - van der Oest, Mark J.W.

AU - Sun, P. O.

AU - Schrier, V. J.M.M.

AU - Hoogendam, L.

AU - Teunissen, J. S.

AU - Stege, M. ter

AU - Duraku, L. S.

AU - Halbesma, G. J.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Purpose: Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery. Methods: Patients who planned to undergo a CTR were asked to fill out the Brief Illness Perception Questionnaire and the Patient Health Questionnaire before surgery to measure their illness perceptions and mental health status, respectively. Return to work was defined as the time until returning to work for 50% of normal hours and was measured using a questionnaire at 6 weeks, 3 months, and 6 months. To identify associations between nonpsychological and psychological patient factors and the return to work after CTR surgery, a Cox proportional hazards model was constructed. Results: In total, 615 patients were included in our study. Six months after surgery, 91% of the patients returned to work. For the psychological patient factors, we found that increases of 1 point on the items of worrying about carpal tunnel syndrome and having faith preoperatively in a beneficial effect of the CTR surgery were associated with hazard ratios of 0.92 (95% confidence interval, 0.88–0.96) and 1.10 (95% confidence interval, 1.02–1.19), respectively, for returning to work in the first 6 months after surgery. An increase of 1 point on the depression subscale of the Patient Health Questionnaire was associated with a hazard ratio of 0.88 (95% confidence interval, 0.78–0.99) for returning to work in the first 6 months after surgery. Conclusions: Our study showed that multiple psychological patient factors are associated with return to work after a CTR surgery. Addressing these psychological factors before surgery might be a low-cost intervention to improve return to work after the CTR surgery. Type of study/level of evidence: Prognostic II.

AB - Purpose: Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery. Methods: Patients who planned to undergo a CTR were asked to fill out the Brief Illness Perception Questionnaire and the Patient Health Questionnaire before surgery to measure their illness perceptions and mental health status, respectively. Return to work was defined as the time until returning to work for 50% of normal hours and was measured using a questionnaire at 6 weeks, 3 months, and 6 months. To identify associations between nonpsychological and psychological patient factors and the return to work after CTR surgery, a Cox proportional hazards model was constructed. Results: In total, 615 patients were included in our study. Six months after surgery, 91% of the patients returned to work. For the psychological patient factors, we found that increases of 1 point on the items of worrying about carpal tunnel syndrome and having faith preoperatively in a beneficial effect of the CTR surgery were associated with hazard ratios of 0.92 (95% confidence interval, 0.88–0.96) and 1.10 (95% confidence interval, 1.02–1.19), respectively, for returning to work in the first 6 months after surgery. An increase of 1 point on the depression subscale of the Patient Health Questionnaire was associated with a hazard ratio of 0.88 (95% confidence interval, 0.78–0.99) for returning to work in the first 6 months after surgery. Conclusions: Our study showed that multiple psychological patient factors are associated with return to work after a CTR surgery. Addressing these psychological factors before surgery might be a low-cost intervention to improve return to work after the CTR surgery. Type of study/level of evidence: Prognostic II.

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U2 - 10.1016/j.jhsa.2021.04.002

DO - 10.1016/j.jhsa.2021.04.002

M3 - Article

AN - SCOPUS:85113347993

SN - 0363-5023

VL - 46

SP - 748

EP - 757

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

IS - 9

ER -

The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

Abstract

Bibliographical note

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