Dupont Marcel, Araghi Kasra, Shinn Daniel, Qureshi Sheeraz, Iyer Sravisht
Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
HSS J. 2024 May;20(2):282-287. doi: 10.1177/15563316221147193. Epub 2023 Jan 27.
Grit, defined as perseverance and passion for long-term goals, and self-control, defined as the capacity to regulate impulses in the presence of momentarily gratifying temptations or diversion, have shown to be predictors of professional achievement. Their role in health care outcomes is less well understood. : We sought to determine whether grit and self-control are associated with patient-reported outcome measures (PROMs) following spine surgery. : We conducted a retrospective review of adult patients who underwent cervical or lumbar procedures by a single fellowship-trained spine surgeon between March 2017 and October 2020. We included patients who underwent anterior cervical discectomy and fusion, cervical disk replacement, minimally invasive laminectomy/laminoplasty (MI-D), or minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with minimum 1-year follow-up. Grit and self-control scores were collected 1 year after the surgery. PROMs were collected preoperatively and at 6 postoperative timepoints. Grit and self-control were compared between patients who achieved substantial clinical benefit (SCB) in either physical or mental health versus those who did not. The association between grit/self-control and change in PROMs was also assessed. : In the 129 patients included in the analysis, we found that patients who achieved SCB in mental health had significantly higher grit scores than those who did not. In bivariate analysis, self-control was associated with greater improvement in leg pain scores at 1-year and 2-year follow-up following an MI-D. For the MI-TLIF cohort, grit was associated with a smaller change in Short Form 12 mental component score at 6 weeks, and self-control was associated with a smaller change in Patient-Reported Outcome Measurement Information System Physical Function at the 6-month timepoint. Grit and self-control were not associated with PROMs at other timepoints. : This retrospective review found that grit and self-control were not significantly associated with PROMs at most postoperative timepoints in patients who underwent spine surgery.
毅力，被定义为对长期目标的坚持不懈和热情，以及自我控制，被定义为在面临即时满足的诱惑或干扰时调节冲动的能力，已被证明是职业成就的预测因素。它们在医疗保健结果中的作用尚不太清楚。我们试图确定毅力和自我控制是否与脊柱手术后患者报告的结局指标（PROMs）相关。我们对2017年3月至2020年10月期间由一位接受过脊柱外科专科培训的外科医生进行颈椎或腰椎手术的成年患者进行了回顾性研究。我们纳入了接受前路颈椎间盘切除融合术、颈椎间盘置换术、微创椎板切除术/椎板成形术（MI-D）或微创经椎间孔腰椎椎间融合术（MI-TLIF）且至少随访1年的患者。术后1年收集毅力和自我控制得分。术前和术后6个时间点收集PROMs。比较在身体或心理健康方面获得显著临床益处（SCB）的患者与未获得显著临床益处的患者之间的毅力和自我控制情况。还评估了毅力/自我控制与PROMs变化之间的关联。在纳入分析的129例患者中，我们发现心理健康获得SCB的患者的毅力得分显著高于未获得SCB的患者。在双变量分析中，自我控制与MI-D术后1年和2年随访时腿痛评分的更大改善相关。对于MI-TLIF队列，毅力与6周时简短健康调查问卷精神成分得分的较小变化相关，自我控制与6个月时患者报告结局测量信息系统身体功能的较小变化相关。在其他时间点，毅力和自我控制与PROMs无关。这项回顾性研究发现，在接受脊柱手术的患者中，在大多数术后时间点，毅力和自我控制与PROMs无显著关联。
