Department of Plastic & Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Plastic & Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Hand and Wrist Center, Xpert Clinic, The Netherlands.
J Psychosom Res. 2019 Nov;126:109820. doi: 10.1016/j.jpsychores.2019.109820. Epub 2019 Aug 28.
To examine the influence of illness perceptions, pain catastrophizing and psychological distress on self-reported symptom severity and functional status in patients diagnosed with carpal tunnel syndrome (CTS).
A total of 674 patients with CTS scheduled for surgery at an outpatient treatment center for hand and wrist conditions (September 2017 to August 2018) completed online questionnaires regarding demographic and psychosocial characteristics and self-reported CTS severity. Self-reported severity of CTS was measured with the functional status scale and the symptom severity scale of the Boston Carpal Tunnel Questionnaire. To measure psychosocial factors, the Patient Health Questionnaire-4, Pain Catastrophizing Scale and the Brief Illness Perception Questionnaire were used. Pearson correlation coefficients were calculated to assess univariable relations. Hierarchical linear regression models were used to examine the relation between psychosocial factors and self-reported severity, and the relative contribution of psychosocial factors to self-reported severity, adjusting for patient characteristics and comorbidities.
Medium-sized correlations (range 0.32-0.44) with self-reported severity were observed for psychological distress, pain catastrophizing, consequences, identity, concern and emotional representation. Furthermore, these factors (except for concern) were also associated with self-reported severity, when adjusted for baseline characteristics and comorbidities. Hierarchical linear regression models showed that these psychosocial factors explained an additional 20-25% of the variance in self-reported severity of CTS.
This study shows that psychological distress, pain catastrophizing and illness perceptions play an independent role in self-reported severity of CTS. Clinicians should take these psychosocial factors into account when they are consulted by patients with CTS.
探讨疾病认知、疼痛灾难化和心理困扰对腕管综合征（CTS）患者自我报告症状严重程度和功能状态的影响。
2017 年 9 月至 2018 年 8 月，在一家手部和腕部疾病门诊治疗中心接受手术的 674 名 CTS 患者完成了关于人口统计学和社会心理特征以及自我报告 CTS 严重程度的在线问卷。自我报告的 CTS 严重程度通过波士顿腕管问卷的功能状态量表和症状严重程度量表进行测量。为了测量社会心理因素，使用了患者健康问卷-4、疼痛灾难化量表和简要疾病认知问卷。计算 Pearson 相关系数以评估单变量关系。使用分层线性回归模型来检验社会心理因素与自我报告严重程度之间的关系，以及社会心理因素对自我报告严重程度的相对贡献，同时调整患者特征和合并症。
观察到心理困扰、疼痛灾难化、后果、身份、关注和情绪表达与自我报告的严重程度呈中等相关（范围为 0.32-0.44）。此外，在调整基线特征和合并症后，这些因素（除关注外）也与自我报告的 CTS 严重程度相关。分层线性回归模型显示，这些社会心理因素解释了 CTS 自我报告严重程度的额外 20-25%的差异。
本研究表明，心理困扰、疼痛灾难化和疾病认知在自我报告的 CTS 严重程度中起独立作用。当 CTS 患者向临床医生咨询时，临床医生应考虑这些社会心理因素。
