Predicting symptoms of post-traumatic stress among patients undergoing orthopedic surgery on the basis of routinely collected cardiovascular data.
Female; Male; Aged; Heart Rate; Sample Size; Arthroplasty; Knee; Blood Pressure; Human; Descriptive Statistics; Funding Source; P-Value; Scales; Evaluation Research; Middle Age; Clinical Assessment Tools; Impact of Events Scale; Outcomes (Health Care); Power Analysis; T-Tests; Replacement; Stress Disorders; Center for Epidemiological Studies Depression Scale; Cardiovascular System; Predictive Research; Post-Traumatic – Symptoms
Cremeans-Smith Julie K; Krupko Thomas A; Greene Kenneth; Delahanty Douglas L
Journal of Health Psychology
2013
2013-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1359105312438110" target="_blank" rel="noreferrer noopener">10.1177/1359105312438110</a>
Sleep Disruptions Mediate the Relationship Between Early Postoperative Pain and Later Functioning Following Total Knee Replacement Surgery.
CHRONIC pain; TOTAL knee replacement; KNEE surgery; POSTOPERATIVE pain; POSTOPERATIVE period; SLEEP
Despite relatively standardized surgical procedures, patients undergoing total knee replacement (TKR) surgery differ dramatically in the speed of their recovery. Previous research has suggested a relationship between the experience of pain and sleep disruptions among patients with chronic pain or those undergoing surgery, such that more severe pain is associated with more frequent awakenings throughout the night. This study examined sleep disruptions 1 month following surgery as a mediator of the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. A total of 110 patients scheduled to undergo unilateral TKR were examined at three time points: 2–3 weeks prior to surgery, 1 month following surgery, and 3 months following surgery. After controlling for presurgical levels of pain, sleep disruptions, and functional limitations, sleep disruptions 1 month following surgery partially mediated the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. The present findings underscore the importance of adequate sleep during postsurgical recovery and suggest that interventions targeting sleep disruptions may improve the speed and quality of patients’ recovery from TKR and other surgical procedures. [ABSTRACT FROM AUTHOR]
Cremeans-Smith Julie K; Millington Kendra; Sledjeski Eve; Greene Kenneth; Delahanty Douglas L
Journal of Behavioral Medicine
2006
2006-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10865-005-9045-0" target="_blank" rel="noreferrer noopener">10.1007/s10865-005-9045-0</a>
Patients’ reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion.
PATIENTS; TOTAL knee replacement; HEALTH outcome assessment; KNEE surgery; POSTOPERATIVE pain; RANGE of motion of joints
The present study examines the reasons cited by 103 patients for their electing to undergo total knee arthroplastic surgery and the relationship between these reasons and their post-operative pain and range of motion. Results suggest that individuals who describe different reasons for undergoing surgery vary in their post-operative recovery. Specifically, patients who cite pain as the reason they are undergoing surgery report greater levels of pain during the early post-operative period. In contrast, patients who describe goals of regaining mobility or a specific activity as their reason for undergoing surgery achieve a greater range of motion during early post-operative physical therapy. Individuals who express avoidance goals for undergoing total knee arthroplasty report more severe post-operative pain at 1 and 3 months following surgery compared to patients who express approach goals. Interventions targeted towards patients reporting pre-operative pain or avoidance goals may decrease subsequent post-operative pain and increase mobility. [ABSTRACT FROM AUTHOR]
Cremeans-Smith Julie K; Boarts Jessica M; Greene Kenneth; Delahanty Douglas L
Journal of Behavioral Medicine
2009
2009-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10865-008-9191-2" target="_blank" rel="noreferrer noopener">10.1007/s10865-008-9191-2</a>
Trauma history as a resilience factor for patients recovering from total knee replacement surgery.
Female; Male; Ohio; Aged; Risk Factors; Pain Measurement; Arthroplasty; Psychological Tests; Human; Descriptive Statistics; Funding Source; Scales; Middle Age; Coefficient Alpha; Effect Size; Clinical Assessment Tools; Impact of Events Scale; T-Tests; Trauma; Stress; Recovery; Replacement; Psychological; Post-Traumatic; Stress Disorders; STATISTICS; RESEARCH funding; POST-traumatic stress disorder; DESCRIPTIVE statistics; TREATMENT effectiveness; CONVALESCENCE; CORRELATION (Statistics); EFFECT sizes (Statistics); LIFE change events; LIFE skills; OHIO; PAIN measurement; PSYCHOLOGICAL tests; REHABILITATION; RESILIENCE (Personality trait); STRESS (Psychology); T-test (Statistics); TOTAL knee replacement; WOUNDS & injuries; Treatment Outcomes; Bivariate Statistics; Center for Epidemiological Studies Depression Scale; Functional Status; Hardiness; 80 and Over; Knee – Psychosocial Factors; Knee – Rehabilitation; TOTAL knee replacement – Psychological aspects
Research concerning the impact of trauma history on individuals' ability to cope with subsequent events is mixed. While many studies find that trauma history increases vulnerability for conditions such as post-traumatic stress disorder and chronic pain, others reveal that there are benefits associated with moderate levels of stress (e.g. development of coping skills). Objective: The present study investigated whether the experience of prior traumatic stressors would serve as a risk or resilience factor based on physical and emotional outcomes among patients recovering from total knee replacement surgery (TKR). Design: 110 patients undergoing unilateral, TKR completed surveys before surgery, as well as one and three months following the procedure. Results: Contrary to hypotheses, patients who reported more prior traumas experienced less severe pain and functional limitations at one- (β = −.259,p = .006) and three-month follow-up assessments (β = −.187,p = .04). A similar pattern emerged when specific types of traumas (e.g. interpersonal) were examined in relation to physical recovery. Further, patients’ trauma history was negatively related to symptoms of post-traumatic stress three-months following surgery (e.g. Avoidance:β = −.200,p = .037). Conclusion: Trauma history represents a source of resilience, rather than vulnerability, within the context of arthroplastic surgery. [ABSTRACT FROM PUBLISHER]
Cremeans-Smith Julie K; Greene Kenneth; Delahanty Douglas L
Psychology & Health
2015
2015-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/08870446.2014.1001391" target="_blank" rel="noreferrer noopener">10.1080/08870446.2014.1001391</a>
Using established predictors of post-traumatic stress to explain variations in recovery outcomes among orthopedic patients.
*Recovery of Function; 80 and over; 80 and Over; activity; Adult; adults; Aged; Arthroplasty; Clinical Assessment Tools; Coefficient Alpha; Comorbidity; Depression; Descriptive Statistics; disability; Disabled; distress; Female; Funding Source; health care; Hip Fractures – Surgery; Hip/*psychology; Human; Humans; Knee; Knee/*psychology; Male; Middle Age; Middle Aged; Ohio; Orthopedic Surgery; outcomes; P-Value; Pain; Pain Measurement; Post-Traumatic – Risk Factors; Post-Traumatic/*etiology; Prospective Studies; Record Review; Recovery; Regression; Regression Analysis; Replacement; Risk Assessment; Scales; Stress Disorders; T-Tests; Treatment Outcomes; Walking
The present studies examine whether information contained in medical records can be used to predict outcomes following two orthopedic procedures: repair of hip fracture and total knee replacement. Study 1 reports the acute, in-hospital recovery data from the medical records of 119 hip fracture patients. Study 2 is a prospective, longitudinal investigation of 3-month postoperative recovery of 110 total knee replacement patients. Patients characterized by a greater number of post-traumatic stress risk factors experienced poorer outcomes following orthopedic surgery. Our results suggest that patients at risk for negative outcomes can be identified by information readily available to medical personnel.
Cremeans-Smith Julie K; Contrera Kevin; Speering Leann; Miller Eric T; Pfefferle Kiel; Greene Kenneth; Delahanty Douglas L
Journal of Health Psychology
2015
2015-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1359105313511135" target="_blank" rel="noreferrer noopener">10.1177/1359105313511135</a>
Physiological Indices of Stress Prior to and Following Total Knee Arthroplasty Predict the Occurrence of Severe Post-Operative Pain.
*Cardiovascular; *Cortisol; *Epinephrine; *Post-operative Pain; *Severity of Illness Index; *Stress; *Surgery; 80 and over; 80 and Over; Aged; Arthroplasty; Catecholamines – Urine; Center for Epidemiological Studies Depression Scale; Cohort Studies; Data Analysis Software; Descriptive Statistics; Effect Size; Female; Human; Humans; Hydrocortisone – Urine; Knee; Knee/*adverse effects/psychology; Male; Middle Age; Middle Aged; Nonexperimental Studies; Ohio; Pain; Pain Measurement/methods; Physiological; Postoperative Pain – Risk Factors; Postoperative/*diagnosis/etiology/*psychology; Predictive Value of Tests; Prospective Studies; Psychological/complications/*diagnosis/*psychology; Regression; Replacement; Scales; Stress; Summated Rating Scaling; Treatment Outcome
OBJECTIVE: The severe pain and disability associated with osteoarthritis often motivate individuals to undergo arthroplastic surgery. However, a significant number of surgical patients continue to experience pain following surgery. Prior research has implicated both the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) in the sensitization of pain receptors and chronic pain conditions. This study uses a prospective, observational, cohort design to examine whether physiological stress responses before and after surgery could predict post-operative pain severity. SUBJECTS: Participants included 110 patients undergoing total knee arthroplasty. METHODS: Physiological indices of stress included the measurement of catecholamine and cortisol levels in 15-hour urine samples collected prior to and 1 month following surgery, as well as in-hospital heart rate and blood pressure (before and after surgery), which were abstracted from medical records. Patients completed the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Bellamy et al., J Orthop Rheumatol 1: , 95 (1988)] 2.5 weeks prior to surgery and at a
Cremeans-Smith Julie K; Greene Kenneth; Delahanty Douglas L
Pain medicine (Malden, Mass.)
2016
2016-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/pm/pnv043" target="_blank" rel="noreferrer noopener">10.1093/pm/pnv043</a>