The Effects of Patient Resilience and Catastrophizing on Carpal Tunnel Surgical Outcomes

Abstract

Purpose: Outcomes following carpal tunnel release (CTR) are generally favorable. When patient satisfaction or symptom resolution is not as expected, understanding what factors contribute to that outcome could allow for strategies targeted at improving results. Our purpose was to determine if measurable mental health factors, specifically resilience and pain catastrophization, correlate with patients' postoperative outcomes following CTR. Methods: A prospective cohort study was performed. Ninety-four patients were recruited to take part in the study. Patients completed written consent, the Boston Carpal Tunnel Questionnaire (BCTQ), the Pain Catastrophizing Scale, and the Brief Resilience Scale. A single surgeon, or his resident under supervision, performed an open CTR under local anesthetic. Our primary outcome measure was a repeat BCTQ at 6 months. Pearson correlation coefficients and univariate analyses were performed to assess the correlation between Pain Catastrophizing Scale and Brief Resilience Scale scores and final BCTQ scores. Results: Forty-three and 63 participants completed the BCTQ at 3 and 6 months, respectively. This was 10% below the number needed to achieve appropriate power. Among those that responded, all participants showed improvement in their symptoms (P ¼ .001). There was no correlation between patients' Pain Catastrophizing Scale or Brief Resilience Scale scores and 6-month BCTQ scores or the amount of improvement in the BCTQ at final follow-up. Conclusions: Most participants improved following CTR. Patients' self-assessed resilience, and the degree of pain catastrophization did no correlate with the amount of improvement patients had after surgery. Type of study/level of evidence: Prognostic II.

Resilience correlates with patient-reported outcome measures at a minimum of 2 years after arthroscopic rotator cuff repair

“…17 Similarly, resilience did not correlate with 3 or 6-month Boston Carpal Tunnel Questionnaire scores after carpal tunnel release. 18 In contrast to the study by Drayer et al, Chavez et al 19 found that in patients who underwent arthroscopic knee surgery, resilience did not correlate with postoperative pain and functional scores at 3 and 6-months. Similarly, we found that preoperative resilience did not correlate with the overall ASES score.…”

Is This Going to Hurt, Doc? Predicting Pain with Corticosteroid Injections for Upper Extremity Conditions

“…It can provide valuable information on patient resilience for health outcomes. 16,17 The primary aim of this study was to compare physician-and patient-predicted pain tolerance with patientreported pain during injection. Additionally, we aimed to study the relationship between predicted pain tolerance, resilience, pain interference, predicted pain of injection, and pain before injection.…”

Association of Preoperative Patient Resilience With Postoperative Patient-Reported Outcomes and Sleep Quality Following Arthroscopic Rotator Cuff Repair: A Systematic Review

“…Positive psychology factors include satisfaction with life, gratitude, coping through humor, resilience, mindfulness, and optimism [14]. Resilience, defined as the ability to bounce back from stress or injury, is a specific aspect of positive psychology that has been investigated across multiple areas within orthopedic surgery including total joint arthroplasty, anterior cruciate ligament reconstruction, spine surgery, foot and ankle surgery, and upper extremity surgery, with varying conclusions regarding the association between preoperative resilience and postoperative outcomes [15][16][17][18][19][20].…”