Julian A Stewart1,2, Vera Aebischer3, Niklaus Egloff4,5, Barbara Wegmann4, Roland von Känel6,5, Esther Vögelin5,7, Martin Grosse Holtforth4,3. 1. Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland. julian.stewart@insel.ch. 2. Department of Psychology, University of Bern, Bern, Switzerland. julian.stewart@insel.ch. 3. Department of Psychology, University of Bern, Bern, Switzerland. 4. Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland. 5. Department of BioMedical Research, University of Bern, Bern, Switzerland. 6. Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland. 7. Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.
Abstract
PURPOSE: Psychological factors have shown to be associated with treatment outcomes in hand injury patients. This study aimed to investigate the role of health locus of control (HLOC) and its dimensions internal, social-external, and fatalistic-external HLOC in treatment outcomes of hand injury patients. METHOD: One hundred thirty-two consecutive patients of a tertiary center for hand surgery undergoing treatment for acute hand injury or degenerative hand problems were included in this study. Pretreatment levels of depression, anxiety, HLOC, and pain intensity were measured, along with pain intensity levels at 4-month follow-up. Hierarchical regression analyses were calculated to test for moderation effects of the HLOC dimensions on the relationship between pretreatment and follow-up pain intensity. RESULTS: Controlling for age, gender, treatment modality, source of hand pain, and depressive symptoms, a moderation effect emerged (β = - 0.16, p < 0.05), such that among patients higher in initial pain intensity, those lower in social-external HLOC experienced higher pain intensity at follow-up compared to those with high social-external HLOC. Internal HLOC and fatalistic-external HLOC did not moderate the effect of initial pain intensity on pain intensity at follow-up. CONCLUSION: Hand injury patients suffering greater initial pain intensity who also had lower versus higher social-external HLOC experienced less favorable treatment outcome. This finding suggests that if patients with high initial pain succeed in transferring perceived health control to professionals and to gain confidence in treatment and clinicians, treatment outcome could be improved in hand surgery.
PURPOSE: Psychological factors have shown to be associated with treatment outcomes in hand injurypatients. This study aimed to investigate the role of health locus of control (HLOC) and its dimensions internal, social-external, and fatalistic-external HLOC in treatment outcomes of hand injurypatients. METHOD: One hundred thirty-two consecutive patients of a tertiary center for hand surgery undergoing treatment for acute hand injury or degenerative hand problems were included in this study. Pretreatment levels of depression, anxiety, HLOC, and pain intensity were measured, along with pain intensity levels at 4-month follow-up. Hierarchical regression analyses were calculated to test for moderation effects of the HLOC dimensions on the relationship between pretreatment and follow-up pain intensity. RESULTS: Controlling for age, gender, treatment modality, source of hand pain, and depressive symptoms, a moderation effect emerged (β = - 0.16, p < 0.05), such that among patients higher in initial pain intensity, those lower in social-external HLOC experienced higher pain intensity at follow-up compared to those with high social-external HLOC. Internal HLOC and fatalistic-external HLOC did not moderate the effect of initial pain intensity on pain intensity at follow-up. CONCLUSION:Hand injurypatients suffering greater initial pain intensity who also had lower versus higher social-external HLOC experienced less favorable treatment outcome. This finding suggests that if patients with high initial pain succeed in transferring perceived health control to professionals and to gain confidence in treatment and clinicians, treatment outcome could be improved in hand surgery.
Entities:
Keywords:
Chronic pain; Depression; Hand injury; Hand surgery; Health locus of control
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