The Nordal Clinic, P.A., Vicksburg, Mississippi 39183, USA.
J Hand Ther. 2010 Apr-Jun;23(2):199-210; quiz 211. doi: 10.1016/j.jht.2009.09.001. Epub 2010 Feb 10.
Pain is considered a fundamental ramification of hand injury and has been identified as one of the most acutely stressful aspects of traumatic injuries and their treatment. Both comorbid psychiatric conditions and psychosocial factors have been shown to affect medical treatment outcome in patients with hand disorders and pain, further complicating recovery and potentially leading to significant psychological, social, and economic consequences for the individual. The purpose of this article was to assist hand therapists in developing a greater understanding of psychological constructs, psychosocial variables, and comorbid psychiatric conditions and thereby facilitate the more effective identification of such factors. A case study is included to illustrate these concepts. Circumstances in which referral for a comprehensive psychological evaluation is necessary are discussed. Many of the principles reviewed are also applicable to other upper extremity and musculoskeletal conditions.
疼痛被认为是手部损伤的一个基本后果，已被确定为创伤性损伤及其治疗中最急性应激的方面之一。合并的精神疾病和社会心理因素已被证明会影响手部疾病和疼痛患者的医疗治疗结果，这进一步使康复复杂化，并可能给个人带来重大的心理、社会和经济后果。本文的目的是帮助手部治疗师更好地理解心理结构、社会心理变量和合并的精神疾病，从而更有效地识别这些因素。本文纳入了一个案例研究来说明这些概念。讨论了需要进行全面心理评估的情况。本文回顾的许多原则也适用于其他上肢和肌肉骨骼疾病。
