Psychological distress levels in patients of total knee arthroplasty and their adherence to home exercise program – A correlational study

Abstract

Older people commonly experience life stressors such as reduced mobility, chronic pain, and fatigue. This leads to loneliness, isolation, and psychological distress among them, putting them at risk of developing mental and psychological disorders such as depression, dementia and anxiety. In older people, total knee arthroplasty (TKA) is one of the most common orthopedic surgeries undertaken. For physical therapeutic rehabilitation, home exercise programs (HEPs) are prescribed post-surgery. These programs require a lot of self-motivation which is reduced in those with mental illnesses. The objectives of this study were to assess the psychological distress levels in patients, to assess their HEP adherence, and, lastly, to study whether there is a correlation between the patient’s psychological distress levels and their HEP adherence. Forty-three subjects who underwent TKA were recruited during their post-operative hospital stay. Their demographic data and date of surgery were collected. At 1 month postoperatively, they were sent a Google form comprising two questionnaires-subsection B of the exercise adherence rating scale and patient health questionnaire-4 to measure adherence to HEP and psychological distress levels. Obtained scores were correlated using Spearman’s test. The confidence interval and P value were set at 95% and <0.05, respectively. The mean age of the 43 subjects was 62.58 ± 9.15. Spearman’s correlation coefficient (r) was −0.47, that is, a moderate negative correlation was found and the P value obtained was 0.02 which is statistically significant. Psychological distress levels have a negative correlation with HEP adherence in patients with TKA.