Erwin Emily R, Ray Keisha S, Han Shuyang
Department of Orthopedic Surgery, McGovern Medical School, 6431 Fannin Street, Houston, TX, 77030, USA.
McGovern Center for Humanities & Ethics, McGovern Medical School, 6431 Fannin Street, Houston, TX, 77030, USA.
J Clin Orthop Trauma. 2023 Dec 12;47:102313. doi: 10.1016/j.jcot.2023.102313. eCollection 2023 Dec.
Orthopedic surgery is commonly considered "quality of life care," as most orthopedic procedures have been shown to provide excellent pain relief and successful surgical outcomes for patients. Although orthopedic surgeries continue to improve patients' functional outcomes through modern surgical techniques and preoperative psychological screening, variation in patient function persists in current studies. Sub-optimal function in patients has been shown to be associated with emotional health burdens, such as anxiety and depression. Previous research has found that preoperative psychological conditions could negatively affect patients' functional outcomes. However, these studies were limited in that they did not examine novel psychological repercussions in emotionally healthy patients following surgery. To address this gap in knowledge, a narrative review was conducted to differentiate specific orthopedic surgeries that have psychological consequences on patients and to determine the current psychological support available for these patients. Data was collected from the Medical Humanities sector of the Texas Medical Center Library and the National Library of Medicine. Studies were included that examined novel psychological effects on patients after undergoing orthopedic surgery. A total of 38 articles were identified, and the majority focused on orthopedic trauma surgery while the rest examined total joint arthroplasty and orthopedic sports procedures. A key finding was that orthopedic trauma surgeries, alone and compared to total joint arthroplasty, result in a greater risk of negative psychological effects, while there was limited data on the psychological effects of orthopedic sports procedures. This narrative review suggests a need to integrate psychosocial support for patients with traumatic orthopedic intervention, regardless of the patient's preoperative psychological state. Furthermore, more research examining the mental well-being of patients following elective orthopedic surgeries is necessary to determine if these operations would benefit from postoperative psychological support as well.
骨科手术通常被视为“生活质量护理”，因为大多数骨科手术已被证明能为患者提供出色的疼痛缓解和成功的手术效果。尽管骨科手术通过现代手术技术和术前心理筛查不断改善患者的功能结局，但在当前研究中，患者功能仍存在差异。患者功能欠佳已被证明与焦虑和抑郁等情绪健康负担有关。先前的研究发现，术前心理状况可能会对患者的功能结局产生负面影响。然而，这些研究存在局限性，即它们没有考察情绪健康的患者术后新出现的心理影响。为了填补这一知识空白，进行了一项叙述性综述，以区分对患者有心理影响的特定骨科手术，并确定目前可用于这些患者的心理支持。数据收集自德克萨斯医学中心图书馆的医学人文部门和国家医学图书馆。纳入的研究考察了骨科手术后对患者的新心理影响。共识别出38篇文章，其中大多数聚焦于骨科创伤手术，其余的则考察了全关节置换术和骨科运动手术。一个关键发现是，与全关节置换术相比，单独的骨科创伤手术会带来更大的负面心理影响风险，而关于骨科运动手术心理影响的数据有限。这篇叙述性综述表明，无论患者术前心理状态如何，都需要为接受创伤性骨科干预的患者提供心理社会支持。此外，有必要进行更多研究，考察择期骨科手术后患者的心理健康状况，以确定这些手术是否也能从术后心理支持中获益。
