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>
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>
Cognitive behavioral therapy for psychosis in clinical practice.
Adaptation; Affect; Cognitive Behavioral Therapy/*methods; Cognitive Therapy – Methods; Coping; Delusions; Descriptive Statistics; Effect Size; Funding Source; Hallucinations; Hallucinations/psychology/therapy; Human; Humans; Meta Analysis; Professional-Patient Relations; Psychological; Psychotic Disorders – Therapy; Psychotic Disorders/psychology/*therapy; Schizophrenia; Schizophrenia/therapy; Schizophrenic Psychology; Secondary Prevention; Systematic Review; Treatment Outcome; United Kingdom; United States
Across two continents, Cognitive-Behavioral Therapy for Psychosis (CBT-P) has been endorsed as an adjunctive treatment for individuals who experience persistent positive symptoms of schizophrenia. The moderate effect sizes reported in early studies and reviews were followed by better controlled studies indicating more limited effect sizes. This article provides a review of the literature that addresses the effectiveness of CBT-P, including particular areas of emphasis and practice elements associated with this approach. In addition, because the majority of research on CBT-P has been performed in the United Kingdom, implications for implementation and sustainability of this practice in the United States are presented.
Sivec Harry J; Montesano Vicki L
Psychotherapy (Chicago, Ill.)
2012
2012-06
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/10.1037/a0028256" target="_blank" rel="noreferrer noopener">10.1037/a0028256</a>