Badura-Brzoza Karina, Zajac Piotr, Brzoza Zenon, Kasperska-Zajac Alicja, Matysiakiewicz Jerzy, Piegza Magdalena, Hese Robert T, Rogala Barbara, Semenowicz Jacek, Koczy Bogdan
Chair and Clinical Department of Psychiatry in Tarnowskie Góry, Medical University of Silesia in Katowice, ul. Pyskowicka 49, 42-612 Tarnowskie Góry, Poland.
Eur Psychiatry. 2009 Mar;24(2):119-24. doi: 10.1016/j.eurpsy.2008.06.009. Epub 2008 Oct 2.
Total hip replacement is one of the most successful orthopaedic interventions in improving considerably the patients' performance, nevertheless some patients demonstrate declined functional ability following an operation. Such condition is not a consequence of medical illness or the surgery itself but might rather be associated with mental status. The authors conduct an investigation concerning the relation between some psychological and psychiatric factors and their influence on health-related quality of life in patients after total hip replacement.
Into the study group we included 102 subjects undergoing total hip replacement (59 female, 43 male). In all subjects we measured depression (Beck Depression Inventory - BDI), anxiety (State and Trait Anxiety Inventory - STAI), sense of coherence (SOC-29), personality traits (Eysenck Personality Inventory - EPI) and health related quality of life (SF-36).
The postoperative values of the PCS and the MCS for the whole group of patients correlated negatively with the SOC values (p=0.04 and p=0.03 respectively). Neuroticism (EPI) and anxiety as a trait (STAI) were also associated with postoperative performance, both in mental (p=0.03 and p=0.008 respectively) and physical (p=0.005 and p=0.04 respectively terms).
Total hip replacement improves significantly the patient's health-related quality of life at 6months after surgery, what is influenced by sense of coherence, neuroticism and anxiety as a trait. Above mentioned factors should be taken into account when rehabilitation and social readaptation processes are planned.
全髋关节置换术是改善患者功能最成功的骨科手术之一,然而一些患者术后功能能力却出现下降。这种情况并非由疾病或手术本身导致,而可能与心理状态有关。作者对一些心理和精神因素及其对全髋关节置换术后患者健康相关生活质量的影响之间的关系进行了调查。
研究组纳入102例行全髋关节置换术的患者(59例女性,43例男性)。对所有受试者测量抑郁(贝克抑郁量表 - BDI)、焦虑(状态 - 特质焦虑量表 - STAI)、连贯感(SOC - 29)、人格特质(艾森克人格问卷 - EPI)以及健康相关生活质量(SF - 36)。
整个患者组的PCS和MCS术后值与SOC值呈负相关(分别为p = 0.04和p = 0.03)。神经质(EPI)和特质焦虑(STAI)也与术后表现相关,在心理方面(分别为p = 0.03和p = 0.008)和身体方面(分别为p = 0.005和p = 0.04)均如此。
全髋关节置换术在术后6个月能显著改善患者的健康相关生活质量,这受到连贯感、神经质和特质焦虑的影响。在规划康复和社会重新适应过程时应考虑上述因素。