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消极情绪、D型人格、生活质量与全膝关节置换术的功能障碍性结果

Negative Affect, Type D Personality, Quality of Life, and Dysfunctional Outcomes of Total Knee Arthroplasty.

作者信息

Vogel Matthias, Riediger Christian, Krippl Martin, Frommer Jörg, Lohmann Christoph, Illiger Sebastian

机构信息

Universitätsklinik für Psychosomatische Medizin und Psychotherapie der Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany.

Institut für Psychologie der Otto-von-Guericke-Universität Magdeburg, Universitätsplatz 2, Geb. 24, 39106 Magdeburg, Germany.

出版信息

Pain Res Manag. 2019 Jan 3;2019:6393101. doi: 10.1155/2019/6393101. eCollection 2019.

Abstract

BACKGROUND

Type D personality (TDP) is a sign of tapered stress and compromises treatment outcomes including those of hip arthroplasty. The common dissatisfaction with total knee arthroplasty (TKA) is predicted by fear avoidance, pain catastrophizing and emotional lability, with poor quality of life (QoL) reflecting these strains. This study is the first to investigate the influence of TDP on TKA assuming (1) negative affect (NA) to be linked to fear avoidance and to increased dissatisfaction with TKA and (2) the expression of NA and social inhibition (SI) to not be stable over time.

METHOD

We studied 79 participants using the brief symptom inventory-18, the pain-catastrophizing scale, the Tampa scale of kinesiophobia, the SF-36, and the WOMAC preoperatively and 12 months postoperatively. -test and regression were used to compare the variables of interest between groups built based upon outcome severity.

RESULT

NA at follow-up predicted knee pain (=0.02) and knee function ( < 0.01) at follow-up. Contrarily, increased expressions of NA/SI at follow-up were predicted by NA (=0.04) and rumination (=0.05) at the baseline.

CONCLUSION

The present results suggest the postoperative increase of NA to be linked to dysfunctional outcomes of TKA due to an interaction with pain catastrophizing. Baseline self-rated physical health did not connect to the dissatisfaction with TKA 1-year postoperatively.

摘要

背景

D型人格(TDP)是压力逐渐增大的一种表现,会影响包括髋关节置换术在内的治疗效果。全膝关节置换术(TKA)常见的不满意情况可通过恐惧回避、疼痛灾难化和情绪不稳定来预测,生活质量(QoL)较差则反映了这些压力。本研究首次调查TDP对TKA的影响,假设(1)消极情感(NA)与恐惧回避相关,并与对TKA的不满增加有关;(2)NA和社交抑制(SI)的表达不会随时间稳定。

方法

我们使用简明症状量表-18、疼痛灾难化量表、坦帕运动恐惧量表、SF-36和WOMAC对79名参与者进行术前和术后12个月的研究。采用t检验和回归分析比较基于结局严重程度分组的感兴趣变量。

结果

随访时的NA可预测随访时的膝关节疼痛(P=0.02)和膝关节功能(P<0.01)。相反,随访时NA/SI表达增加可由基线时的NA(P=0.04)和沉思(P=0.05)预测。

结论

目前的结果表明,术后NA的增加与TKA的功能不良结局有关,这是由于与疼痛灾难化相互作用所致。基线时的自评身体健康状况与术后1年对TKA的不满无关。

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