The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

Haas, Nicoline P. de; Zuidam, J. Michiel; Blomme, R.A.M.; Sluijter, Berbel J.R.; Avoort, D.J.J.C. van der; Kroeze, A.; Smit, Jeroen M.; Debeij, J.; Walbeehm, Erik T.; Couwelaar, G.M. van; Vermeulen, Guus M.; Schipper, J.P. de; Temming, J.F.M.; Uchelen, J.H. van; Boer, H.L. de; Haas, Kirsten; Harmsen, K.; Zöphel, Oliver T.; Feitz, Reinier; Souer, J. Sebastiaan; Koch, Richard S; Hovius, Steven E.R.; Moojen, Thybout M.; Smit, Xander; Huis, R. van; Pennehouat, P.Y.; Schoneveld, K.; Kooij, Y.E. van; Wouters, Robbert M.; Zagt, P.; Ewijk, F.J. van; Veltkamp, J.J.; Fink, A. K.; Ridder, W.A. de; Slijper, Harm P.; Selles, Ruud W.; Porsius, Jarry T.; Tsehaie, Jonathan; Poelstra, Ralph; Jansen, Miguel C.; Sun, P.O.; Schrier, Verena J.M.M.; Hoogendam, Lisa; Teunissen, Joris S; Dekker, Jak; Jansen-Landheer, M.L.E.A.; Stege, M. ter; Duraku, Liron S.; Halbesma, G.J.

doi:10.1016/j.jhsa.2021.04.002

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Analysis of preoperative psychological mindsets, based on several questionnaires, seems to be important for predicting the outcome of surgery [29]. Return to work after surgery for CTS is also influenced by illness perception and mental health [17], which seems to be particularly relevant for treated women for CTS where depression predicts outcome [16]. In the present study, a low income as well as a low occupational qualification level were associated with an increased odds ratio for use of psychotropic drugs over and above other factors.…”

Section: Discussionmentioning

confidence: 99%

“…Socioeconomic factors have been discussed in the context of the risk of being diagnosed and treated for CTS in particular [7][8][9][10][11][12], but has been less highlighted for UNE [1,13,14]. More importantly, the recognition and addressing of psychological health early is crucial in decision-making before performing surgery for CTS and UNE [15], and also an important factor to consider during rehabilitation [16], and it may influence return to work after carpal tunnel surgery [17]. The use of psychotropics (i.e., psycholeptics, antidepressants, and psycholeptics and psychoanaleptics in combination) can be considered as a proxy or indicator for impaired psychological health, especially in highly accessible health care systems such as the Swedish system, and can be used to evaluate if a condition is associated with impaired psychological health [18].…”

Section: Introductionmentioning

confidence: 99%

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Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication

Dahlin

Perez

Nyman

et al. 2022

JCM

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We aimed to study psychological health, as approximated by the use of psychotropic drugs, in a population diagnosed and surgically treated for carpal tunnel syndrome (CTS) or ulnar nerve entrapment (UNE), or both, also considering the demographic and socioeconomic factors of the individuals. Linking data from five large national registers, use of psychotropics (at least one dispensation during the first year after the surgery or the baseline date) was examined in around 5.8 million people 25–80 years old residing in Sweden 2010. Among these individuals, 9728 (0.17%), 890 (0.02%) and 149 (0.00%) were identified as diagnosed and surgically treated for CTS, UNE, or both, respectively. As much as 28%, 34% and 36% in each group, respectively, used psychotropic drugs, compared with 19% in the general population. Regression analyses showed a general higher risk for use of psychotropics related to these nerve compression disorders, to higher age, being a woman, and having low income or low occupational qualification level. Individuals born outside of Sweden had a lower risk. We conclude that surgically treated individuals with a nerve compression disorder have an increased risk of impaired psychological health. Caregivers should be aware of the risk and provide necessary attention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication

Dahlin

Perez

Nyman

et al. 2022

JCM

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“…Illness perception, pain catastrophizing, depression, and patients' expectations regarding surgery may influence treatment outcomes [8,11,13,14].…”

Section: Introductionmentioning

confidence: 99%

Analysis of concerns among patients operated for carpal tunnel syndrome

Napora¹,

Gryglewsk²,

Piotrowicz³

et al. 2021

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. Carpal tunnel release (CTR) is among the most commonly performed procedures within a hand, in a day surgery setting. Studies suggest that patient concerns and emotional state may influence CTR outcomes. Aim. To determine the frequency of preoperative concerns among patients operated for carpal tunnel syndrome (CTS) and their correlation with negative emotions, socio-demographic and clinical variables. Materials and methods. A total of 72 patients (81.9% women) scheduled for CTR were included in the study. Pain, anxiety, irritability, and depression were measured using the Visual Analogue Scale (VAS) on the day of surgery. Tailor-made questionnaires were used to explore patients’ concerns and to gather socio-demographic and clinical data. Statistical analysis was performed utilizing R language. α < 0.05 was considered significant. Results. At least one concern was declared by the vast majority of patients (93.1%). Postoperative pain was the most prevalent concern, declared by 49.3% of participants. “Outcomes will not meet my expectations” was a concern for 43.3% of participants. Concern related to intraoperative complications was declared by 34.3% of participants. Patients scheduled for CTR had high mean VAS scores of anxiety and irritability and low score of depression. Anxiety reached the highest level among measured variables. Patients who declared postoperative pain had statistically significantly higher levels of pain, anxiety, irritability, and depression than patients without this concern. Concern that surgery outcomes will not meet patient’s expectations was declared statistically significantly more frequently by patients with any surgery in history. Conclusions. Preoperative concerns among patients operated for carpal tunnel syndrome are extremely prevalent. Those concerns are accompanied by a high level of negative emotions. Therefore assessment of emotional status, addressing particular concerns, and tailored preoperative intervention, all are of crucial importance. A meticulous approach to postoperative pain and patients’ expectations regarding outcomes seem to be essential. The mentioned strategy may positively influence patients’ comfort and surgery outcomes.

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“…[7][8][9] Ultimately, the time to RTW after CTR is traditionally understood as a complex process, influenced by patient, surgeon, procedural, and socioeconomic factors. [7][8][9][10] CTR with ultrasound (CTR-US) guidance is a less invasive surgical alternative that may expedite patient recovery periods compared with other CTR procedures. CTR-US involves a minimal incision, typically less than 1 cm, to access and divide the transverse carpal ligament (TCL).…”

mentioning

confidence: 99%

Early Return to Work after Carpal Tunnel Release with Ultrasound Guidance

Paterson,

Kirsch,

Miller

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: The duration of postoperative leave varies by the carpal tunnel release (CTR) technique. This study aimed to determine the time to return to work (RTW) after CTR with ultrasound (CTR-US) guidance and identify factors contributing to this duration. Methods: This was a multicenter postmarket registry of patients treated with CTR-US. Time to RTW was analyzed with Kaplan–Meier methods. Logistic regression identified the association of patient, work, and procedural factors with the probability of RTW within 5 days (a standard work week) after CTR-US. Results: A total of 544 employed patients (655 hands) from 24 centers were treated with CTR-US between November 2019 and August 2022. The mean patient age was 50 years, 62% were women, and most (76%) were full-time employees, where work activities were desk-based (49%), light manual (28%), or heavy manual (23%). The complication rate was 0.8%. After CTR-US, the median RTW was 3 days (interquartile range: 1–6 days), with 74.6% returning by 5 days, 87.8% by 10 days, and 97.1% by 30 days. Work activity (desk-based versus heavy manual: odds ratio = 2.93, 95% confidence interval: 1.70–5.04, P < 0.001) and sex (man versus woman: odds ratio = 1.85, 95% confidence interval: 1.15–2.98, P = 0.01) were associated with higher probability of RTW within 5 days. The median RTW ranged from 2 to 4 days in all patient subgroups, including heavy manual laborers (median 4 days) and women (median 3 days). Conclusions: CTR-US offers an efficient approach to treating CTS, enabling most patients to RTW with minimal delay. The short recovery periods observed across diverse patient and work characteristic subgroups compare favorably to other CTR techniques.

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The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

Cited by 7 publications

References 29 publications

Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication

Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication

Analysis of concerns among patients operated for carpal tunnel syndrome

Early Return to Work after Carpal Tunnel Release with Ultrasound Guidance

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