Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands; Hand and Wrist Center, Xpert Clinics, Eindhoven, the Netherlands; Center for Hand Therapy, Xpert Handtherapie, Eindhoven, the Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands; Hand and Wrist Center, Xpert Clinics, Eindhoven, the Netherlands.
J Psychosom Res. 2024 Oct;185:111861. doi: 10.1016/j.jpsychores.2024.111861. Epub 2024 Jul 27.
Baseline mindset factors are important factors that influence treatment decisions and outcomes. Theoretically, improving the mindset prior to treatment may improve treatment decisions and outcomes. This prospective cohort study evaluated changes in patients' mindset following hand surgeon consultation. Additionally, we assessed if the change in illness perception differed between surgical and nonsurgical patients.
The primary outcome was illness perception, measured using the total score of the Brief Illness Perception Questionnaire (B-IPQ, range 0-80). Secondary outcomes were the B-IPQ subscales, pain catastrophizing (measured using the Pain Catastrophizing Scale (PCS)), and psychological distress (measured using the Patient Health Questionnaire-4).
A total of 276 patients with various hand and wrist conditions completed the mindset questionnaires before and after hand surgeon consultation (median time interval: 15 days). The B-IPQ total score improved from 39.7 (±10.6) before to 35.8 (±11.3) after consultation (p < 0.0001, Cohen's d = 0.36); scores also improved for the B-IPQ subscales Coherence, Concern, Emotional Response, Timeline, Treatment Control, and Identity and the PCS. There were no changes in the other outcomes. Surgical patients improved on the B-IPQ subscales Treatment Control and Timeline, while nonsurgical patients did not.
Illness perception and pain catastrophizing improved following hand surgeon consultation, suggesting that clinicians may actively influence the patients' mindset during consultations, and that they may try to enhance this effect to improve outcomes. Furthermore, surgical patients improved more in illness perceptions, indicating that nonsurgical patients may benefit from a more targeted strategy for changing mindset.
基线思维因素是影响治疗决策和结果的重要因素。理论上，在治疗前改善思维模式可能会改善治疗决策和结果。这项前瞻性队列研究评估了手部外科医生咨询后患者思维模式的变化。此外，我们还评估了手术和非手术患者的疾病感知变化是否不同。
主要结局是使用简短疾病感知问卷（B-IPQ）的总分（范围 0-80）测量的疾病感知。次要结局是 B-IPQ 分量表、疼痛灾难化（使用疼痛灾难化量表（PCS）测量）和心理困扰（使用患者健康问卷-4 测量）。
共有 276 名患有各种手部和腕部疾病的患者在手部外科医生咨询前后完成了思维模式问卷（中位数时间间隔：15 天）。B-IPQ 总分从咨询前的 39.7（±10.6）提高到咨询后的 35.8（±11.3）（p<0.0001，Cohen's d=0.36）；B-IPQ 分量表的一致性、关注、情绪反应、时间线、治疗控制和身份以及 PCS 的分数也有所提高。其他结果没有变化。手术患者在治疗控制和时间线的 B-IPQ 分量表上有所改善，而非手术患者则没有。
手部外科医生咨询后，疾病感知和疼痛灾难化有所改善，这表明临床医生可能会在咨询过程中积极影响患者的思维模式，他们可能会尝试增强这种效果以改善结果。此外，手术患者的疾病认知改善更多，表明非手术患者可能受益于更有针对性的改变思维模式的策略。
