Quality of Life and Psychosocial Factors as Predictors of Pain Relief Following Nerve Surgery

Abstract

Background: Peripheral nerve injuries may result in pain, disability, and decreased quality of life (QoL). Pain is an incompletely understood experience and is associated with emotional and behavioral qualities. We hypothesized that pain following peripheral nerve surgery could be predicted by changes in emotions or QoL postoperatively. Methods: Using prospectively collected data, a retrospective study design was used to evaluate the relationships among pain, QoL, and psychosocial factors in patients who underwent peripheral nerve surgery. Patients completed questionnaires rating pain; impact of pain on QoL, sadness, depression, frustration, anger, and hopefulness before surgery; and each postoperative follow-up visit. Multilevel modeling was used to assess the concurrent and lagged relationships between pain and psychosocial factors. Results: Increased pain was concurrently associated with decreased hopefulness ( P = .001) and increased the impact on QoL, sadness, depression, and anger ( P < .001). In lagged analyses, the impact on QoL and anger prospectively predicted pain ( P < .001 and P = .02, respectively). Pain predicted subsequent scores of QoL, sadness, depression, anger, and hopefulness ( P < .01). Having an upper limb nerve injury and self-report of “no comment for childhood trauma” were predictors of postsurgical pain. Conclusion: Psychosocial measures and pain are reciprocally related among patients who underwent surgery for peripheral nerve injuries or compression. Our study provides evidence of the important relationships among psychosocial factors, pain, and outcome and identifies treatment targets following nerve surgery.

Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media

“…The ZCMEI-21 has been previously validated in German language [9] and included four subscales: "ear signs and symptoms" (items 1-5), "hearing function" (items 6-10), "psychosocial impact" (items [11][12][13][14][15][16][17][18], and the "use of medical resources" (items [19][20][21]. All answers are presented using a 5-point Likert scale.…”

“…Particularly, studies in orthopedics and pain therapy demonstrated that patients with mental health disorders have been associated with less postoperative improvement [17,18]. In patient-reported outcome measures (PROMs), patients with anxiety and depression felt that interventions were less beneficial compared to others without these comorbidities [19][20][21][22]. Given that depressiveness affects the perception of chronical illness [23][24][25], depressive disorders may modulate the relationship between COM symptom burden and the decrease in HRQOL in patients with COM.…”

Beyond the Knife—Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions

“…The same applies to the predictive value of a positive history childhood trauma for nextvisit sadness and depression. It has been suggested that this correlation is caused by trauma-induced changes to the brain of abused or traumatized children [47,79,80]. In this context, one should consider the fact that about 10% of American youth have experienced at least one episode of sexual assault and 9-19% were subject to physical abuse or a physical assault by the respective caregiver [81].…”

“…Next-visit sadness and depression could be predicted in case the patient reported a positive history of childhood trauma, which was the case in 7.9% of study sample. While 89.3% of the patients denied childhood trauma, 2.8% refused to comment on this question [47]. In conclusion, the listed studies' results suggest that surgeons should be aware of the fact that functional recovery following repair of peripheral nerve lesions can be significantly influenced by the prevalence of postoperative stress and pain-catastrophizing.…”

Chronic Nerve Injuries and Delays in Surgical Treatment Negatively Impact Patient-reported Quality of Life

“… 1 Furthermore, chronic pain may interfere with ability to work, sleep, engage in social activities, and ability to pursue leisure or hobbies. 1 Pain has been demonstrated to be specifically predictive of negative changes in QoL and mood, 6 and the reported intensity of a patient’s pain has been shown to be predictive of the level of disability imparted by the nerve injury. 2 , 3 …”