Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain.

Détails

Ressource 1Télécharger: BIB_E99735A57C08.pdf (474.96 [Ko])
Etat: Public
Version: de l'auteur⸱e
ID Serval
serval:BIB_E99735A57C08
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain.
Périodique
Clinical orthopaedics and related research
Auteur⸱e⸱s
Wolfensberger A., Vuistiner P., Konzelmann M., Plomb-Holmes C., Léger B., Luthi F.
ISSN
1528-1132 (Electronic)
ISSN-L
0009-921X
Statut éditorial
Publié
Date de publication
09/2016
Peer-reviewed
Oui
Volume
474
Numéro
9
Pages
2030-2039
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Validated clinician outcome scores are considered less associated with psychosocial factors than patient-reported outcome measurements (PROMs). This belief may lead to misconceptions if both instruments are related to similar factors.
We asked: In patients with chronic shoulder pain, what biopsychosocial factors are associated (1) with PROMs, and (2) with clinician-rated outcome measurements?
All new patients between the ages of 18 and 65 with chronic shoulder pain from a unilateral shoulder injury admitted to a Swiss rehabilitation teaching hospital between May 2012 and January 2015 were screened for potential contributing biopsychosocial factors. During the study period, 314 patients were screened, and after applying prespecified criteria, 158 patients were evaluated. The median symptom duration was 9 months (interquartile range, 5.5-15 months), and 72% of the patients (114 patients) had rotator cuff tears, most of which were work injuries (59%, 93 patients) and were followed for a mean of 31.6 days (SD, 7.5 days). Exclusion criteria were concomitant injuries in another location, major or minor upper limb neuropathy, and inability to understand the validated available versions of PROMs. The PROMs were the DASH, the Brief Pain Inventory, and the Patient Global Impression of Change, before and after treatment (physiotherapy, cognitive therapy and vocational training). The Constant-Murley score was used as a clinician-rated outcome measurement. Statistical models were used to estimate associations between biopsychosocial factors and outcomes.
Greater disability on the DASH was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.64; 95% CI, 0.25-1.03; p = 0.002) and social factors (language, professional qualification combined coefficient, -6.15; 95% CI, -11.09 to -1.22; p = 0.015). Greater pain on the Brief Pain Inventory was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale combined coefficient, 0.076; 95% CI, 0.021-0.13; p = 0.006). Poorer impression of change was associated with psychological factors (Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia coefficient, 0.93; 95% CI, 0.87-0.99; p = 0.026) and social factors (education, language, and professional qualification coefficient, 6.67; 95% CI, 2.77-16.10; p < 0.001). Worse clinician-rated outcome was associated only with psychological factors (Hospital Anxiety and Depression Scale (depression only), Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia combined coefficient, -0.35; 95% CI, -0.58 to -0.12; p = 0.003).
Depressive symptoms and catastrophizing appear to be key factors influencing PROMs and clinician-rated outcomes. This study suggests revisiting the Constant-Murley score.
Level III, prognostic study.

Mots-clé
Adolescent, Adult, Aged, Catastrophization/psychology, Chronic Pain/diagnosis, Chronic Pain/physiopathology, Chronic Pain/psychology, Chronic Pain/therapy, Depression/psychology, Disability Evaluation, Female, Hospitals, Teaching, Humans, Linear Models, Logistic Models, Male, Middle Aged, Multivariate Analysis, Pain Measurement, Patient Reported Outcome Measures, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Shoulder Injuries/diagnosis, Shoulder Injuries/physiopathology, Shoulder Injuries/psychology, Shoulder Injuries/therapy, Shoulder Pain/diagnosis, Shoulder Pain/physiopathology, Shoulder Pain/psychology, Shoulder Pain/therapy, Switzerland, Time Factors, Treatment Outcome, Young Adult
Pubmed
Open Access
Oui
Création de la notice
28/07/2016 15:55
Dernière modification de la notice
20/08/2019 16:12
Données d'usage