Schwartz Carolyn E, Rapkin Bruce D, Sniderman Jhase, Finkelstein Joel A
DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA.
Departments of Medicine and Orthopaedic Surgery, Tufts University School of Medicine, Boston, MA, USA.
J Patient Rep Outcomes. 2022 Sep 5;6(1):93. doi: 10.1186/s41687-022-00498-z.
Total hip arthroplasty (THA) is a successful procedure that provides pain relief, restores function, and improves quality of life (QOL) for patients with advanced arthritis in their hip joint. To date, little research has examined the role of cognitive appraisal processes in THA outcomes. This study examined the role of cognitive appraisal processes in THA outcomes in the first year post-surgery.
This longitudinal cohort study collected data at pre-surgery, 6 weeks post-surgery, 3 months post-surgery, and 12 months post-surgery. Adults (n = 189) with a primary diagnosis of osteoarthritis were consecutively recruited from an active THA practice at a Canadian academic teaching hospital. Measures included the Hip Disability and Osteoarthritis Outcome Score (HOOS), the Mental Component Score (MCS) of the Rand-36, and the Brief Appraisal Inventory (BAI). Analysis of Variance examined the association between BAI items and the HOOS or MCS scores. Random effects models investigated appraisal main effects and appraisal-by-time interactions for selected BAI items.
HOOS showed great improvement over the first 12 months after THA, and was mitigated by three appraisal processes in particular: focusing on problems with healthcare or living situation, and preparing one's family for health changes. MCS was stable and low over time, and the following appraisal processes were implicated by very large effect sizes: not comparing themselves to healthier people, focusing on money problems, preparing their family for their health changes, or trying to shed responsibilities.
Appraisal processes are relevant to health outcomes after THA, with different processes coming into play at different points in the recovery trajectory.
全髋关节置换术（THA）是一种成功的手术，可为髋关节晚期关节炎患者缓解疼痛、恢复功能并提高生活质量（QOL）。迄今为止，很少有研究探讨认知评估过程在全髋关节置换术结果中的作用。本研究考察了认知评估过程在术后第一年全髋关节置换术结果中的作用。
这项纵向队列研究在术前、术后6周、术后3个月和术后12个月收集数据。从加拿大一所学术教学医院的一个活跃的全髋关节置换术科室连续招募了189名初步诊断为骨关节炎的成年人。测量指标包括髋关节残疾和骨关节炎结果评分（HOOS）、兰德36项健康调查简表的心理成分评分（MCS）以及简要评估量表（BAI）。方差分析检验了BAI项目与HOOS或MCS评分之间的关联。随机效应模型研究了选定BAI项目的评估主效应和评估与时间的交互作用。
全髋关节置换术后的前12个月，HOOS有显著改善，尤其是三个评估过程减轻了这种改善：关注医疗保健或生活状况问题，以及让家人为健康变化做好准备。随着时间的推移，MCS保持稳定且较低，以下评估过程的效应量非常大：不与更健康的人比较，关注金钱问题，让家人为自己的健康变化做好准备，或试图推卸责任。
评估过程与全髋关节置换术后的健康结果相关，不同的过程在恢复轨迹的不同阶段发挥作用。
