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Rhee SM, Kim DH, Kim SH, Jeong HJ, Oh JH. The Clinical Outcomes and Their Associated Factors in Staged Bilateral Arthroscopic Rotator Cuff Repair. Arthroscopy 2018; 34:2799-2807. [PMID: 30195959 DOI: 10.1016/j.arthro.2018.06.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare perioperative characteristics and postoperative outcomes of both shoulders in patients who underwent arthroscopic bilateral rotator cuff repair sequentially and to assess the associated factors that would affect the anatomic healing in staged bilateral rotator cuff repair. METHODS The study enrolled 64 patients who underwent bilateral rotator cuff repair with follow-up imaging at least 12 months postoperatively. We allocated the shoulders operated on first to the surgery I group and those operated on second to the surgery II group. Visual analog scale (VAS) pain and satisfaction scores, range of motion, the American Shoulder and Elbow Surgeons score, the Simple Shoulder Test score, and healing failure were evaluated. RESULTS Range of motion improved with no significant between-group differences (all P > .05). In the surgery II group, VAS pain and VAS satisfaction scores were significantly worse at 6 months postoperatively (P = .048 and P = .041, respectively) but were comparable at final follow-up (P = .598 and P = .065, respectively). American Shoulder and Elbow Surgeons and Simple Shoulder Test scores at 6 months were worse in the surgery II group (P = .038 and P = .048, respectively) but similar at final follow-up (P = .786 and P = .087, respectively). Tear size was similar between the 2 surgical procedures (κ = 0.537, P < .001). Of the 11 patients with nonhealing in the surgery I group, 7 (63.6%) had subsequent failure in the other shoulder, and if one shoulder had healing failure, the other shoulder had a high possibility of healing failure as well (κ = 0.373, P = .004). CONCLUSIONS Bilateral arthroscopic rotator cuff repair showed good outcomes at final follow-up on both sides. Tear size was closely related in both shoulders, and healing failure after the first rotator cuff repair was an associated factor with healing failure after the second operation. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Sung-Min Rhee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | | | - Sae Hoon Kim
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon Jang Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Joo Han Oh
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
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Kühlmann AYR, de Rooij A, Kroese LF, van Dijk M, Hunink MGM, Jeekel J. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg 2018; 105:773-783. [PMID: 29665028 PMCID: PMC6175460 DOI: 10.1002/bjs.10853] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/08/2017] [Accepted: 02/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. METHODS Eleven electronic databases were searched for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. RESULTS Ninety-two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta-analysis. Music interventions significantly decreased anxiety (MD -0·69, 95 per cent c.i. -0·88 to -0·50; P < 0·001) and pain (MD -0·50, -0·66 to -0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100-mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD -1·41 (-1·89 to -0·94; P < 0·001) for anxiety and -0·54 (-0·93 to -0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD -0·41, -0·64 to -0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high. CONCLUSION Music interventions significantly reduce anxiety and pain in adult surgical patients.
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Affiliation(s)
- A Y R Kühlmann
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A de Rooij
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L F Kroese
- Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M van Dijk
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M G M Hunink
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J Jeekel
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
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Influência dos sintomas de ansiedade e depressão na qualidade de vida em pacientes submetidos à artrodese de coluna lombar. Rev Bras Ortop 2018. [DOI: 10.1016/j.rbo.2017.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hefti E, Remington M, Lavallee C. Hospital consumer assessment of healthcare providers and systems scores relating to pain following the incorporation of clinical pharmacists into patient education prior to joint replacement surgery. Pharm Pract (Granada) 2017; 15:1071. [PMID: 29317922 PMCID: PMC5741999 DOI: 10.18549/pharmpract.2017.04.1071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/15/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Pharmacist involvement has been shown to improve various aspects of patient care. Patients undergoing knee and hip replacement surgery generally experience post-operative pain and discomfort. Pain control can impact patient satisfaction, as reported by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Objective: The current pilot study aims to measure the potential impact that incorporating pharmacists into preoperative patient education programs has on the response to select HCAHPS questions. Methods: Patient responses to two select HCAHPS questions related to pain were recorded for a year prior to pharmacist involvement in a comprehensive preoperative patient education program (2012) and a year after pharmacists became actively involved (2013). Results: In all reporting surgical patients, there was a modest 3.68% improvement in mean scores reflecting patient’s feelings that hospital staff did “everything they could” to attend to their pain (mean2012=3.66, SD=0.63 versus mean2013=3.80, SD=0.43, p=0.018, Mann-Whitney U test). There was a non-significant 2.98% improvement in scores reflecting the level that pain was “well controlled” (mean2012=3.54, SD=0.651 versus mean2013=3.65, SD=0.554, p=0.069, Mann-Whitney U test) in surgical patients. Conclusion: The results suggest comprehensive pharmacist involvement in patient education prior to joint replacement surgery may impact HCAHPS scores related to pain control. While the observed potential improvements were modest, the current results justify larger, multi-institution prospective studies to better elucidate the impact pharmacists can have on pain management in patients undergoing joint replacement.
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Affiliation(s)
- Erik Hefti
- Department of Pharmaceutical Services, Sisters of Charity Hospital, St. Joseph Campus. Cheektowaga, NY (United States).
| | - Michael Remington
- Department of Pharmaceutical Services, Sisters of Charity Hospital, St. Joseph Campus. Cheektowaga, NY (United States).
| | - Charles Lavallee
- Department of Pharmaceutical Services, Sisters of Charity Hospital, Main Street Campus. Buffalo, NY (United States).
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Influence of anxiety and depression symptoms on the quality of life in patients undergoing lumbar spine surgery. Rev Bras Ortop 2017; 53:38-44. [PMID: 29367905 PMCID: PMC5771797 DOI: 10.1016/j.rboe.2017.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/17/2017] [Indexed: 11/24/2022] Open
Abstract
Objective Comparative analysis of the quality of life and functionality of patients undergoing lumbar spine arthrodesis due to degenerative lumbar spine disease. The authors sought to correlate the influence of anxious and depressive symptoms before and after surgery. Methods A prospective cohort study was performed, with 32 patients submitted to arthrodesis due to degenerative lumbar spine disease and the visual analogue pain scale pain questionnaire, the Oswestry Disability Index questionnaire, the Medical Outcomes Survey Short Form questionnaire – 36 items (SF-36), and the Hospital Anxiety and Depression Scale, applied in the preoperative period and four months after the procedure. Results There was improvement in the mean scores of the visual analogue pain scale (p < 0.001) and the Oswestry Disability Index (p < 0.001). In the preoperative period, the variables that presented a difference between patients with and without anxiety symptoms were the SF-36 domains of general health (p = 0.031), social aspects (p = 0.008), and mental health (p = 0.035). In the postoperative period, patients without anxiety symptoms showed better results in the vitality (p = 0.004), social aspects (p = 0.001), mental health (p < 0.001), and pain (p = 0.011) domains. In the preoperative period, the variable that presented a difference between patients with and without depression was the SF-36 domain of emotional aspects (p = 0.022). In the post-operative period, patients without depression presented better vitality (p < 0.001), social aspects (p < 0.001), emotional aspects (p = 0.004), and mental health results (p = 0.001). Conclusion Lumbar spine arthrodesis was effective in improving pain, low back pain, functional capacity, limitation due to physical aspects, vitality, and social and emotional aspects. Patients without anxiety and depression symptoms had better results on the scales compared to those with such symptoms.
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Doğru HY, Özsoy F, Doğru S, Karaman T, Şahin A, Özsoy AZ, Çakmak B, Süren M. Catastrophizing, Depression and Anxiety During Pregnancy: Relation Between Lumbopelvic Pain and Physical/Social Functioning. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2017. [DOI: 10.1007/s10942-017-0277-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vergara-Romero M, Morales-Asencio JM, Morales-Fernández A, Canca-Sanchez JC, Rivas-Ruiz F, Reinaldo-Lapuerta JA. Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health Qual Life Outcomes 2017; 15:120. [PMID: 28592310 PMCID: PMC5463326 DOI: 10.1186/s12955-017-0695-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 05/24/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Preoperative anxiety is a frequent and challenging problem with deleterious effects on the development of surgical procedures and postoperative outcomes. To prevent and treat preoperative anxiety effectively, the level of anxiety of patients needs to be assessed through valid and reliable measuring instruments. One such measurement tool is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), of which a Spanish version has not been validated yet. OBJECTIVE To perform a Spanish cultural adaptation and empirical validation of the APAIS for assessing preoperative anxiety in the Spanish population. METHODS A two-step forward/back translation of the APAIS scale was performed to ensure a reliable Spanish cultural adaptation. The final Spanish version of the APAIS questionnaire was administered to 529 patients between the ages of 18 to 70 undergoing elective surgery at hospitals of the Agencia Sanitaria Costa del Sol (Spain). Cronbach's alpha, homogeneity index, intra-class correlation coefficient, and confirmatory factor analysis were calculated to assess internal consistency and criteria and construct validity. RESULTS Confirmatory factor analysis showed that a one-factor model was better fitted than a two-factor model, with good fitting patterns (root mean square error of approximation: 0.05, normed-fit index: 0.99, goodness-of-fit statistic: 0.99). The questionnaire showed high internal consistency (Cronbach's alpha: 0.84) and a good correlation with the Goldberg Anxiety Scale (CCI: 0.62 (95% CI: 0.55 to 0.68). CONCLUSIONS The Spanish version of the APAIS is a valid and reliable preoperative anxiety measurement tool and shows psychometric properties similar to those obtained by similar previous studies.
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Affiliation(s)
- Manuel Vergara-Romero
- Agencia sanitaria costa del sol, Málaga, Marbella Spain
- Hospital Costa del Sol, Autovia A-7 KM, 187 29603 Málaga, Spain
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Bouloux GF, Zerweck AG, Celano M, Dai T, Easley KA. Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy? J Oral Maxillofac Surg 2015; 73:2094-102. [PMID: 26032643 DOI: 10.1016/j.joms.2015.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 04/17/2015] [Accepted: 05/11/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Psychological assessment has been used successfully to predict patient outcomes after cardiothoracic and bariatric surgery. The purpose of this study was to determine whether preoperative psychological assessment could be used to predict patient outcomes after temporomandibular joint arthroscopy. MATERIALS AND METHODS Consecutive patients with temporomandibular dysfunction (TMD) who could benefit from arthroscopy were enrolled in a prospective cohort study. All patients completed the Millon Behavior Medicine Diagnostic survey before surgery. The primary predictor variable was the preoperative psychological scores. The primary outcome variable was the difference in pain between the pre- and postoperative periods. The Spearman rank correlation coefficient and the Pearson product-moment correlation were used to determine the association between psychological factors and change in pain. Univariable and multivariable analyses were performed using a mixed-effects linear model and multiple linear regression. A P value of .05 was considered significant. RESULTS Eighty-six patients were enrolled in the study. Seventy-five patients completed the study and were included in the final analyses. The mean change in visual analog scale (VAS) pain score 1 month after arthroscopy was -15.4 points (95% confidence interval, -6.0 to -24.7; P < .001). Jaw function also improved after surgery (P < .001). No association between change in VAS pain score and each of the 5 preoperative psychological factors was identified with univariable correlation analyses. Multivariable analyses identified that a greater pain decrease was associated with a longer duration of preoperative symptoms (P = .054) and lower chronic anxiety (P = .064). CONCLUSIONS This study has identified a weak association between chronic anxiety and the magnitude of pain decrease after arthroscopy for TMD. Further studies are needed to clarify the role of chronic anxiety in the outcome after surgical procedures for the treatment of TMD.
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Affiliation(s)
- Gary F Bouloux
- Associate Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Ashley G Zerweck
- Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Marianne Celano
- Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Tian Dai
- PhD Student, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kirk A Easley
- Senior Associate, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA
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Solutions for reducing lawsuits in orthopedic surgery by using psychology and IT technology. J Med Life 2015; 8 Spec Issue:47-51. [PMID: 26361511 PMCID: PMC4564044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/11/2015] [Indexed: 11/24/2022] Open
Abstract
Orthopedic surgery is among the top 5 medical specialties with an increased risk of facing a lawsuit. A large part of medical malpractice claims are due to poor communication between physician and patient; therefore, by addressing this issue and implementing psychological methods as well as IT solutions, a reduction in the incidence of medical lawsuits can be achieved. Some of these solutions include implementing and applying psychometric tools such as the SF-36 and SCL-90R tests, creating virtual information hubs for the patient, and establishing efficient communication methods by using IT technology between physician and patient.
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