Attitudes Toward Aging Among Patients With Upper Extremity Illness

Background: An adaptive attitude toward aging might limit symptom intensity and magnitude of limitations. This study sought factors associated with attitudes toward aging (measured with the Brief Aging Perceptions Questionnaire [B-APQ]) and studied the relationship of having an age-related disease to magnitude of limitations, pain intensity, patient satisfaction, and patient comfort with completing a questionnaire about attitudes toward aging. We also looked for a subset of questions from B-APQ that maintained the construct validity and internal consistency of B-APQ, without unacceptable flooring or ceiling effects. Methods: A total of 161 upper extremity patients completed the following questionnaires: B-APQ, Patient Health Questionnaire–Short Form, Pain Self-efficacy–Short Form, Pain Catastrophizing Scale–Short Form, Patient-Reported Outcomes Measurement Information System Physical Function–Upper Extremity, pain intensity, satisfaction with the surgeon, and comfort with completing the B-APQ. We created multivariable linear regression models to test for associations. Results: Factors independently associated with less positive perceptions about aging included white race, retired work status, having nonspecific comorbidities, and more catastrophic thinking. Variation in the magnitude of limitations and pain intensity was accounted for by effectiveness of coping strategies rather than attitudes toward aging in particular. A 4-question version of the B-APQ has acceptable performance. Conclusion: Adaptive attitudes toward aging are associated with psychological and social determinants of health. We present a 4-item short form of B-APQ that could be used as a brief measure to assess attitudes toward aging. Interventions to improve adaptiveness to nociception (eg, cognitive behavioral therapy to limit catastrophic thinking) might help with adaptation to age-related changes.

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Using the Tampa Scale for Kinesiophobia Short Form in Patients With Upper Extremity Specific Limitations

Hand ◽

10.1177/1558944719898830 ◽

2020 ◽

pp. 155894471989883

Author(s):

Joost T. P. Kortlever ◽

Prithvi Karyampudi ◽

Janna S. E. Ottenhoff ◽

David Ring ◽

Gregg A. Vagner ◽

...

Keyword(s):

Physical Function ◽

Upper Extremity ◽

Internal Consistency ◽

Pain Catastrophizing ◽

Short Form ◽

Full Model ◽

Catastrophic Thinking ◽

Patient Reported ◽

Ceiling Effects ◽

Tampa Scale For Kinesiophobia

Background: The Tampa Scale for Kinesiophobia (TSK) is used to quantify fear of painful movement. A shorter form with only 4 questions (TSK-4) can be used by physicians to look for fear of movement independent of catastrophic thinking with less responder and survey burden. We assessed the difference explained in amount of variation in the Patient-Reported Outcomes Measurement Information System Physical Function Upper Extremity (PROMIS PF UE) between the TSK and TSK-4. Additionally, we looked for other factors that were associated with the PROMIS PF UE, and we assessed reliability and validity of the TSK and TSK-4 by looking at mean scaled scores, internal consistency, floor and ceiling effects, interquestionnaire correlations, and collinearity with the Pain Catastrophizing Scale short form (PCS-4), PROMIS Depression, and PROMIS Pain Interference (PROMIS PI). Methods: One hundred forty eight new and follow-up patients were seen at 5 orthopedic clinics in a large urban area and given the TSK, PROMIS PF UE, PROMIS Depression, PROMIS PI, and PCS-4 questionnaires. Results: Both long and short measures of greater fear of painful movement were independently associated with less physical function (PROMIS PF UE). The longer version accounted for more of the variation in physical function than the short version (TSK, semipartial R2 = 0.12, adjusted R2 full model 0.25; TSK-4, semipartial R2 = 0.03, adjusted R2 full model = 0.16, respectively). The shorter measure had slight floor and ceiling effects. There was high internal consistency for both the TSK and TSK-4. Conclusions: A short measure of fear of painful movement may be an adequate screen in the care of patients with upper extremity problems. Using this short form can help decrease questionnaire burden while accounting for kinesiophobia along with catastrophic thinking. Level of Evidence: Prognostic, level II

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Influence of psychological factors on patient-reported upper extremity disability

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193419859373 ◽

2019 ◽

Vol 45 (1) ◽

pp. 71-76

Author(s):

Homan Cheng ◽

Christine B. Novak ◽

Christian Veillette ◽

Herbert P. von Schroeder

Keyword(s):

Health Status ◽

Upper Extremity ◽

Psychosocial Factors ◽

Psychological Factors ◽

Patient Reported Outcomes ◽

Pain Catastrophizing ◽

Short Form ◽

Level Of Evidence ◽

Patient Reported ◽

The Relationship

Disability reflects physical impairment and the influence of psychosocial factors. We investigated the relationship between disability and psychosocial factors in patients with upper extremity pathology. Ninety-two patients at a hand clinic were evaluated to assess disability, pain intensity, health status and psychosocial factors (pain catastrophizing, depression). Statistical analyses evaluated the relationships among disability and patient and psychosocial factors. Moderate levels of disability from all types of pathology were reported and associated with pain catastrophizing, pain and depression. Health status Short Form 36 domains were not correlated with disability as determined by Disabilities of the Arm, Shoulder and Hand (DASH) scores. A strong correlation was found between DASH and QuickDASH scores, but the QuickDASH scored significantly higher by 4 points. Pain catastrophizing was the strongest predictor of disability and explained 59% and 63% of variation in disability scores. Independent of pathology, those patients experiencing psychosocial issues, as well as demographic factors (i.e. employment status and age), were more likely to have disability with hand conditions and surgical procedures. We conclude from this study that psychological factors affect patient-reported outcomes. Level of evidence: IV

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Correlation of the I-HaND Scale with Other Musculoskeletal Patient-Reported Outcome Measurement Scores

Journal of Hand and Microsurgery ◽

10.1055/s-0041-1735348 ◽

2021 ◽

Author(s):

Joost T.P. Kortlever ◽

S. Ryan Pierson ◽

David Ring ◽

Lee M. Reichel ◽

Gregg A. Vagner

Keyword(s):

Pain Intensity ◽

Upper Extremity ◽

Short Form ◽

Multivariable Analysis ◽

Patient Reported Outcome ◽

Specific Patient ◽

Symptoms Of Depression ◽

Patient Reported ◽

The Impact ◽

Hand Scale

Abstract Background Experiments can determine if nerve-specific patient-reported outcome measures (PROMs) can outperform regional or condition-specific PROMs. We compared a nerve-specific PROM of the upper extremity, the Impact of Hand Nerve Disorders (I-HaND) scale, to other validated measures quantifying activity intolerance and sought to assess interquestionnaire correlations and factors independently associated with activity intolerance and pain intensity. Methods One hundred and thirty patients with any upper extremity nerve-related condition completed measures of demographics, psychological limitations, quality of life, activity intolerance, and pain intensity. To quantify activity intolerance, we used the I-HaND, Patient-Reported Outcomes Measurement Information System Physical Function Upper Extremity, and Disabilities of the Arm, Shoulder and Hand short form. Results Strong interquestionnaire correlations were found between the activity intolerance measures (r between 0.70 and 0.91). Multivariable analysis revealed that greater activity intolerance and greater pain intensity correlated most with greater symptoms of depression on all scales, with symptoms of depression accounting for 53 to 84% of the variability in the PROMs. Conclusion There is no clear advantage of the nerve-specific I-HaND over shorter, regional PROMs, perhaps because they are all so closely tied to mental health. Unless an advantage relating to responsiveness to treatment is demonstrated, we support using a brief arm-specific PROM for all upper extremity conditions. Level of Evidence Level II; Prognostic.

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The Influence of Psychological Factors on the Michigan Hand Questionnaire

Hand ◽

10.1177/1558944716642765 ◽

2016 ◽

Vol 12 (2) ◽

pp. 197-201 ◽

Cited By ~ 6

Author(s):

Yekyoo Oh ◽

Tessa Drijkoningen ◽

Mariano E. Menendez ◽

Femke M. A. P. Claessen ◽

David Ring

Keyword(s):

Upper Extremity ◽

Emotional Health ◽

Pain Catastrophizing ◽

Pain Interference ◽

Measurement Information ◽

Web Based ◽

Psychological Measures ◽

Symptoms Of Depression ◽

Patient Reported ◽

Multivariable Regression

Background: Psychosocial factors help account for the gap between impairment and disability. This study examines the relationship between the Michigan Hand Questionnaire (MHQ) and commonly used psychological measures in patients with upper extremity illness. Methods: A cohort of 135 new or follow-up patients presenting to an urban academic hospital–based hand surgeon were invited to complete a web-based version of the MHQ, Abbreviated Pain Catastrophizing Scale (PCS), and two Patient-Reported Outcomes Measurement Information System (PROMIS)-based questionnaires: Pain Interference and Depression. Bivariate and multivariable analyses measured the correlation of these psychological measures with MHQ. Results: Accounting for potential confounding factors in multivariable regression, upper extremity disability as rated by the MHQ was independently associated with PROMIS Depression, PROMIS Pain Interference, visit type, and working status. The model accounted for 37% of the variability in MHQ scores, with PROMIS Pain Interference having the most influence. Conclusion: Among the non-pathophysiological factors that contribute to patient-to-patient variation in MHQ scores, the measure of less effective coping strategies and symptoms of depression were most influential. Our data add to the evidence of the pivotal role of emotional health in upper extremity symptoms and limitations and the importance of psychosocial considerations in the care of hand illness.

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#MadelungDeformity: Insights Into a Rare Congenital Difference Using Social Media

Hand ◽

10.1177/15589447211054133 ◽

2021 ◽

pp. 155894472110541

Author(s):

Abbas Peymani ◽

Max M. Lokhorst ◽

Austin D. Chen ◽

Chantal M.A.M. van der Horst ◽

Bernard T. Lee ◽

...

Keyword(s):

Social Media ◽

Pain Intensity ◽

Upper Extremity ◽

Peer Relationships ◽

Well Being ◽

Global Perspective ◽

Pain Interference ◽

Measurement Information ◽

Madelung Deformity ◽

Patient Reported

Background Madelung deformity is a rare congenital hand difference with little known regarding the patient perspective. In this cross-sectional survey study, we harnessed the global reach of social media to understand the clinical spectrum of Madelung deformity and its impact on physical, mental, and social health. Methods A survey was developed based on a previously published protocol and multiple Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. The survey was distributed on several Madelung deformity communities on Facebook and Instagram. T-scores were calculated, interpreted, and compared between patients who underwent surgery and those who did not. Correlations between scores were calculated using the Spearman rank correlation coefficient. Results Mean PROMIS scores for adults were as follows: pain intensity, 4.9 ± 2.8; pain interference, 57.6 ± 10.0; upper extremity, 35.2 ± 8.1; depression, 53.8 ± 11.1; anxiety, 55.4 ± 11.4; and ability to participate in social roles and activities, 42.5 ± 7.7. Mean scores for children were as follows: pain intensity, 5.0 ± 2.8; pain interference, 55.7 ± 11.3; upper extremity function, 24.6 ± 10.4; depressive symptoms, 57.7 ± 11.3; anxiety, 57.3 ± 11.9; and peer relationships, 42.2 ± 10.3. Conclusions Madelung deformity has significant effects on patients’ physical, mental, and social well-being, even after surgical treatment. Using social media, we were able to compensate for Madelung deformity’s rarity by engaging an international audience, demonstrating the feasibility to conduct research through it, and providing a global perspective of the disease entity.

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Obeid-Coronal Malalignment Classification Is Age Related and Independently Associated to Personal Reported Outcome Measurement Scores in the Nonfused Spine

Neurospine ◽

10.14245/ns.2142458.229 ◽

2021 ◽

Vol 18 (3) ◽

pp. 475-480

Author(s):

David Christopher Kieser ◽

Louis Boissiere ◽

Anouar Bourghli ◽

Kazunori Hayashi ◽

Derek Cawley ◽

...

Keyword(s):

Multivariate Analysis ◽

Spinal Deformity ◽

Short Form ◽

Outcome Measurement ◽

Clear Correlation ◽

Self Image ◽

Age Related ◽

Patient Reported ◽

Mobile Spine ◽

Coronal Malalignment

Objective: To evaluate Obeid-coronal malalignment (O-CM) modifiers according to age, sagittal alignment, and patient-reported outcome measures (PROMs), in the mobile spine.Methods: Retrospective review of a prospective multicenter adult spinal deformity (ASD) database with 1,243 (402 nonoperative, 841 operative) patients with no prior fusion surgery. Patients were included if they were aged over 18 years and were affected by spinal deformity defined by one of: Cobb angle ≥ 20°, pelvic tilt ≥ 25°, sagittal vertical axis ≥ 5 cm, thoracic kyphosis ≥ 60°. Patients were classified according to the O-CM classification and compared to coronally aligned patients. Multivariate analysis was performed on the relationship between PROMs and age, global tilt (GT) and coronal malalignment (CM).Results: Four hundred forty-three patients had CM of more than 2 cm compared to 800 who did not. The distribution of these modifiers was correlated to age. After multivariate analysis, using age and GT as confounding factors, we found that before the age of 50 years, 2A1 patients had worse sex life and greater satisfaction than patients without CM. After 50 years of age, patients with CM (1A1, 1A2) had worse self-image and those with 2A2, 2B had worse self-image, satisfaction, and 36-item Short Form Health Survey physical function. Self-image was the consistent determinant of patients opting for surgery for all ages.Conclusion: CM distribution according to O-CM modifiers is age dependent. A clear correlation between the coronal malalignment and PROMs exists when using the O-CM classification and in the mobile spine, this typically affects self-image and satisfaction. Thus, CM classified according to O-CM modifiers is correlated to PROMs and should be considered in ASD.

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Effect of abiraterone acetate (AA) on patient-reported pain in metastatic castration-resistant prostate cancer (mCRPC) post-docetaxel: Results of longitudinal sensitivity analyses.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9618 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 9618-9618 ◽

Cited By ~ 2

Author(s):

Yanni Hao ◽

Charles S. Cleeland ◽

Dennis Gagnon ◽

Derek Espindle ◽

Arturo Molina ◽

...

Keyword(s):

Missing Data ◽

Pain Intensity ◽

Short Form ◽

Mixed Effects ◽

Pain Interference ◽

Sensitivity Analyses ◽

Repeated Measure ◽

Patient Reported ◽

Pain Outcomes ◽

The Impact

9618 Background: The COU-AA-301 phase 3 trial showed that AA + prednisone (P) improved overall survival in mCRPC patients (pts) post-docetaxel. Compared with P alone, AA + P also had significant benefits on patient-reported pain. Here we describe post hoc sensitivity analyses of pain data from that trial, using different methods to compensate for the potential impact of missing data. Methods: Pts with mCRPC progressing after docetaxel-based chemotherapy were randomized 2:1 to AA + P or placebo + P. Pain intensity and interference of pain with daily activities were assessed with the Brief Pain Inventory-Short Form (BPI-SF) questionnaire at baseline, Day 15 of Cycle 1, and Day 1 of each 28-day treatment cycle thereafter until treatment discontinuation. The effect of treatment on BPI-SF scores was analyzed using repeated measure mixed-effects (RMM) models, piecewise linear mixed-effects (PWLME) models, and joint mixed-effects and log time-to-dropout (JMEL) models. RMM and PWMLE models assumed missing data (due to death, study dropout, or administrative issues) to be missing at random, the JMEL model to be missing not at random. Model results were compared between treatment arms. Results: 797 pts were randomized to AA + P, and 398 to P only. RMM model estimates suggested statistically significant (p < 0.05) differences in change from baseline for pain intensity and pain interference scores in favor of AA + P at the majority of study visits through cycle 11. PWLME models yielded significantly smaller areas under the curve (AUCs) for AA + P vs P for pain intensity (p = 0.0031) and pain interference (p = 0.0006); smaller AUCs reflect better pain outcomes. Results using JMEL models were nearly identical to those with PWLME models, with AUCs for AA + P significantly smaller than for P alone for pain intensity (p = 0.0031) and pain interference (p = 0.0007). Conclusions: Using various modeling methods that assess the impact of missing data, AA + P showed superior patterns of pain outcomes over time compared with P only in mCRPC pts refractory to docetaxel. These results support the previously reported pain benefits of AA + P over P alone from the same trial. Clinical trial information: NCT00638690.

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Modifiable Psychological Factors Affecting Functioning in Fibromyalgia

Journal of Clinical Medicine ◽

10.3390/jcm10040803 ◽

2021 ◽

Vol 10 (4) ◽

pp. 803

Author(s):

Myrella Paschali ◽

Asimina Lazaridou ◽

Theodoros Paschalis ◽

Vitaly Napadow ◽

Robert R. Edwards

Keyword(s):

Linear Regression ◽

Pain Intensity ◽

Psychological Factors ◽

Pain Catastrophizing ◽

Behavioral Therapy ◽

Cross Sectional Study ◽

Important Variable ◽

Self Report ◽

Cross Sectional ◽

Patient Reported

Objective: To examine the role of several interrelated, potentially modifiable psychological factors (i.e., mindfulness and catastrophizing) in influencing patient-reported functioning. Methods: In this cross-sectional study, 107 patients with fibromyalgia completed self-report assessments of pain severity, functioning and impact of symptoms, mindfulness, and pain catastrophizing. Linear regression and bootstrapping mediation analyses were performed to assess the relationships between these factors. Results: Pain intensity was significantly and positively associated with pain catastrophizing and impact of fibromyalgia on functioning. Linear regression analyses indicated that pain intensity, catastrophizing, and mindfulness affect functioning in fibromyalgia. Follow-up mediation analysis revealed a significant indirect effect of pain catastrophizing on the relationship between pain intensity and fibromyalgia functioning. Conclusion: Individuals with fibromyalgia who have higher levels of pain and catastrophizing, and lower levels of mindfulness, are more likely to experience impaired functioning. Our findings suggest that pain catastrophizing appears to be an especially important variable contributing to reduced functioning in women with fibromyalgia. Therefore, catastrophizing-reducing treatments (e.g., cognitive behavioral therapy) are likely to have direct, beneficial impacts on functioning.

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Pain Correlates of Depressed Mood

Pain Research and Management ◽

10.1155/1998/506347 ◽

1998 ◽

Vol 3 (3) ◽

pp. 135-144 ◽

Cited By ~ 12

Author(s):

Trudi M Walsh ◽

Chloé P Smith ◽

Patrick J McGrath

Keyword(s):

Young Adults ◽

Sleep Disturbance ◽

Pain Intensity ◽

Depressed Mood ◽

Pain Catastrophizing ◽

Short Form ◽

Mcgill Pain Questionnaire ◽

Testing Time ◽

Low Levels ◽

Underlying Mechanisms

OBJECTIVE: To provide an initial indication of the intensity and quality of pain in young adults reporting depressed mood and to investigate possible underlying mechanisms.DESIGN: Case-control study.SETTING: University undergraduate subject pool.PARTICIPANTS: Sixty introductory psychology undergraduates classified as either reporting high levels of depressed mood (n=30; age 18.7±0.87 years, mean ± SD) or reporting low levels of depressed mood (n=30; age 18.6±0.81 years).MAIN OUTCOME MEASURES: Beck Depression Inventory, Short-Form McGill Pain Questionnaire, Pain Catastrophizing Scale, Pittsburgh Sleep Quality Index and pressure dolorimeter pain thresholds.RESULTS: Young adults reporting high levels of depressed mood had significantly higher pain intensity at testing time, as measured by a visual analogue scale (P=0.015) and a present pain index (P=0.002), affective pain intensity for the previous month (P=0.000), pain catastrophizing (P=0.025) and global sleep disturbance (P=0.000) than young adults reporting low levels of depressed mood. Within the group of young adults reporting high levels of depressed mood, significantly higher sleep disturbance scores (P=0.020) were identified in those reporting high levels of overall pain intensity.CONCLUSIONS: The results are discussed in terms of their implications for research as well as for the assessment and treatment of pain in individuals with depression.

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Ganglions of the hand and wrist: determinants of treatment choice

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412442468 ◽

2012 ◽

Vol 38 (2) ◽

pp. 151-157 ◽

Cited By ~ 3

Author(s):

F. Peters ◽

A.-M. Vranceanu ◽

M. Elbon ◽

D. Ring

Keyword(s):

Pain Intensity ◽

Operative Treatment ◽

Psychological Factors ◽

Pain Catastrophizing ◽

Ganglion Cyst ◽

Treatment Choice ◽

Pain Anxiety ◽

Catastrophic Thinking ◽

Ordinal Measure ◽

Pain Anxiety Symptoms Scale

The aim of this study was to determine whether psychological factors (depression, catastrophic thinking, and pain anxiety) and pain intensity are associated with choice of operative treatment. Ninety new patients with a ganglion cyst on their hand or wrist completed psychological questionnaires (Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale, and Center for the Epidemiological Study of Depression instrument) and an ordinal measure of pain intensity. After a minimum of 4 months, patients were contacted to determine if they chose operative treatment, to rate their pain intensity, and to complete the Disabilities of the Arm, Shoulder, and Hand questionnaire. Younger patients were more likely to choose operative treatment. Psychological factors were associated with pain intensity at enrolment, but not with treatment choice. Operative treatment did not result in less pain intensity or disability, or higher satisfaction compared with non-operative treatment.

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