影响骨科预后的“十大”心理社会因素

W. Curtis, River Fine, Addi N. Moya, R. Blackstone, Richard M Wardell, Gehron P. Treme, D. Richter
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引用次数: 1

摘要

导读:骨科人群中的许多患者经历一个或更多的心理社会问题,这些问题可能会深刻地影响骨科手术后的预后。尽管这些因素具有共同的性质,但描述其对骨科预后影响的文献却很少。本综述的目的是描述我们的患者群体中最常遇到的10个社会心理因素,它们对骨科结果的影响,以及如何解决它们。这些因素包括期望、对再次伤害的恐惧、社会经济地位、社会支持、过敏、成瘾、抑郁和焦虑、适应力、自我效能和其他精神健康障碍。方法:对pubmed索引的文献进行全面的回顾,使用我们在这里描述的每一个社会心理因素,并结合关键词“骨科预后”。研究设计:这是一篇临床综述论文。证据等级:不适用。结果:这10种心理社会影响对骨科手术后的康复和预后有显著影响。患者受益于手术前后对这些问题的早期认识和管理。结论:本文回顾的每个心理社会因素都对骨科手术后的预后有显著影响。对这些因素的深刻理解以及如何解决这些因素将有助于骨科医生最大限度地提高患者的术后效果。需要进一步的研究来改善我们对这一复杂患者群体的治疗策略。
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The “Top 10” Psychosocial Factors Affecting Orthopaedic Outcomes
Introduction: Many patients within the orthopaedic population experience 1 or more psychosocial issues that may profoundly affect their postoperative outcomes after orthopaedic surgery. Despite the common nature of these factors, there is a paucity of literature describing their effect on orthopaedic outcomes. The purpose of this review was to describe the anecdotal 10 most-encountered psychosocial factors in our patient population, their described influence on orthopaedic outcomes, and how they may be addressed. These factors include expectations, fear of reinjury, socioeconomic status, social support, allergies, addiction, depression and anxiety, resilience, self-efficacy, and other mental health disorders. Methods: A thorough review of the PubMed-indexed literature was conducted using each one of our psychosocial factors described here combined with the key words “orthopaedic outcome.” Study Design: This was a clinical review paper. Level of Evidence: Not applicable. Results: These 10 psychosocial influences have dramatic effects on the recovery and outcomes after orthopaedic procedures. Patients benefit from early recognition and management of these issues before and after surgery. Conclusions: Each of the psychosocial factors reviewed in this paper has a significant influence on outcomes after orthopaedic surgery. A strong understanding of these factors and how to address them will aid orthopaedic surgeons in maximizing postoperative outcomes for their patients. Further research is necessary to improve our treatment strategies for this complex patient population.
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