Patient Mindset and the Success of Carpal Tunnel Release
- 24 December 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 147 (1), 66e-75e
- https://doi.org/10.1097/prs.0000000000007441
Abstract
Background: Depression and pain catastrophizing are aspects of the patient’s mindset that have been shown to be important in relation to the outcome of carpal tunnel release. However, other factors of the patient’s mindset have been understudied, such as treatment expectations and illness perceptions. The aim of the present study was to investigate the influence of these mindset aspects on outcome of carpal tunnel release, in addition to psychological distress and pain catastrophizing. Methods: A total of 307 patients with carpal tunnel syndrome who visited outpatient hand surgery clinics and who completed online questionnaires regarding demographic and psychosocial characteristics and carpal tunnel syndrome severity were included. The patient mindset was measured with the Patient Health Questionnaire-4, the Pain Catastrophizing Scale, the Credibility Expectancy Questionnaire, and the Brief Illness Perception Questionnaire. Hierarchical linear regression models were used to examine the relation between self-reported severity 6 months after carpal tunnel release, as measured with the Boston Carpal Tunnel Questionnaire, and psychosocial aspects of mindset, adjusting for preoperative Boston Carpal Tunnel Questionnaire score, patient characteristics, and comorbidities. Results: Independent associations with better self-reported outcome were found for higher treatment expectations (β = −0.202; p < 0.001) and illness comprehensibility (β = −0.223; p < 0.001). The additional explained variance in Boston Carpal Tunnel Questionnaire scores by the patient’s mindset was 13.2 percent (psychological distress and pain catastrophizing together, 2.1 percent; treatment expectations and illness perceptions together, 11.1 percent). Conclusion: Treatment outcome expectations and comprehensibility of illness are both independently associated with the outcome of carpal tunnel release, showing the importance of these aspects of the patient’s mindset for the outcome of carpal tunnel release. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.Keywords
This publication has 42 references indexed in Scilit:
- Minimal clinically important differences in the Carpal Tunnel Questionnaire after carpal tunnel releaseJournal of Hand Surgery (European Volume), 2012
- Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?Health and Quality of Life Outcomes, 2012
- Pre-operative expectation predicts 12-month post-operative outcome among patients undergoing primary total hip replacement in European orthopaedic centresOsteoarthritis and Cartilage, 2011
- Determinants of Pain in Patients with Carpal Tunnel SyndromeClinical Orthopaedics and Related Research, 2010
- Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months laterJournal of Psychosomatic Research, 2010
- Evaluation of Preoperative Expectations and Patient Satisfaction After Carpal Tunnel ReleaseThe Journal of Hand Surgery, 2008
- Treatment Expectancy and Credibility Are Associated With the Outcome of Both Physical and Cognitive-behavioral Treatment in Chronic Low Back PainThe Clinical Journal of Pain, 2008
- Patient Satisfaction After Open Carpal Tunnel Release Correlates With DepressionThe Journal of Hand Surgery, 2008
- The Pain Catastrophizing Scale: Development and validation.Psychological Assessment, 1995
- Common-sense models of illness: The example of hypertension.Health Psychology, 1985