Department of Psychology, Kent State University at Stark, N Canton, OH 44720, USA.
J Psychosom Res. 2011 Jul;71(1):55-7. doi: 10.1016/j.jpsychores.2010.12.002. Epub 2011 Jan 17.
Prior research has suggested that posttraumatic stress symptoms may occur in the context of medical events. Further, these symptoms are often comorbid with conditions associated with pain. Therefore, the current study examined the occurrence of distress following arthroplastic surgery and the relationship of these symptoms to postoperative recovery.
Patients (N =110) undergoing unilateral, total knee replacement (TKR) surgery were assessed at three time points proximal to their surgery: approximately 2 weeks prior to surgery (T1), 1 month following surgery (T2) and 3 months following surgery (T3). Patients completed survey assessments of recovery outcomes (Western Ontario and McMaster Universities Osteoarthritis Index) and distress (The Impact of Event Scale [IES]) following surgery (T2 and T3).
A significant percentage (20%) of patients undergoing TKR reported noteworthy levels of postsurgical stress 1 and 3 months following surgery. Further, this distress was associated with a more difficult recovery following TKR, characterized by more severe pain and greater functional limitations. After controlling for potential confounding variables, regression analyses suggested that postsurgical stress was cross-sectionally related to pain perception and longitudinally predicted subsequent functional limitations and global assessments of recovery.
To our knowledge, this is the first study to examine postoperative distress (using the IES) following TKR. The present study adds to the growing body of literature documenting the impact of psychological processes on postoperative recovery.
先前的研究表明，创伤后应激症状可能发生在医疗事件的背景下。此外，这些症状通常与与疼痛相关的疾病共病。因此，本研究检查了关节成形术后出现的痛苦，并研究了这些症状与术后恢复的关系。
接受单侧全膝关节置换术（TKR）的患者在手术前 2 周（T1）、手术后 1 个月（T2）和手术后 3 个月（T3）三个时间点接受评估。患者在手术后（T2 和 T3）完成了关于恢复结果（安大略西部和麦克马斯特大学骨关节炎指数）和痛苦（事件影响量表 [IES]）的调查评估。
接受 TKR 的患者中有相当比例（20%）在手术后 1 个月和 3 个月报告了明显的术后压力。此外，这种痛苦与 TKR 后更困难的恢复有关，表现为更严重的疼痛和更大的功能限制。在控制潜在的混杂变量后，回归分析表明，术后应激与疼痛感知呈横断面相关，并纵向预测随后的功能限制和对恢复的总体评估。
据我们所知，这是第一项研究全膝关节置换术后的术后痛苦（使用 IES）的研究。本研究增加了越来越多的文献记录心理过程对术后恢复的影响。
