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The Role of Health Locus of Control in Pain Intensity Outcome of Conservatively and Operatively Treated Hand Surgery Patients


Stewart, Julian A; Aebischer, Vera; Egloff, Niklaus; Wegmann, Barbara; von Känel, Roland; Vögelin, Esther; Grosse Holtforth, Martin (2018). The Role of Health Locus of Control in Pain Intensity Outcome of Conservatively and Operatively Treated Hand Surgery Patients. International Journal of Behavioral Medicine, 25(3):374-379.

Abstract

PURPOSE: Psychological factors have shown to be associated with treatment outcomes in hand injury patients. This study aimed to investigate the role of health locus of control (HLOC) and its dimensions internal, social-external, and fatalistic-external HLOC in treatment outcomes of hand injury patients.
METHOD: One hundred thirty-two consecutive patients of a tertiary center for hand surgery undergoing treatment for acute hand injury or degenerative hand problems were included in this study. Pretreatment levels of depression, anxiety, HLOC, and pain intensity were measured, along with pain intensity levels at 4-month follow-up. Hierarchical regression analyses were calculated to test for moderation effects of the HLOC dimensions on the relationship between pretreatment and follow-up pain intensity.
RESULTS: Controlling for age, gender, treatment modality, source of hand pain, and depressive symptoms, a moderation effect emerged (β = - 0.16, p < 0.05), such that among patients higher in initial pain intensity, those lower in social-external HLOC experienced higher pain intensity at follow-up compared to those with high social-external HLOC. Internal HLOC and fatalistic-external HLOC did not moderate the effect of initial pain intensity on pain intensity at follow-up.
CONCLUSION: Hand injury patients suffering greater initial pain intensity who also had lower versus higher social-external HLOC experienced less favorable treatment outcome. This finding suggests that if patients with high initial pain succeed in transferring perceived health control to professionals and to gain confidence in treatment and clinicians, treatment outcome could be improved in hand surgery

Abstract

PURPOSE: Psychological factors have shown to be associated with treatment outcomes in hand injury patients. This study aimed to investigate the role of health locus of control (HLOC) and its dimensions internal, social-external, and fatalistic-external HLOC in treatment outcomes of hand injury patients.
METHOD: One hundred thirty-two consecutive patients of a tertiary center for hand surgery undergoing treatment for acute hand injury or degenerative hand problems were included in this study. Pretreatment levels of depression, anxiety, HLOC, and pain intensity were measured, along with pain intensity levels at 4-month follow-up. Hierarchical regression analyses were calculated to test for moderation effects of the HLOC dimensions on the relationship between pretreatment and follow-up pain intensity.
RESULTS: Controlling for age, gender, treatment modality, source of hand pain, and depressive symptoms, a moderation effect emerged (β = - 0.16, p < 0.05), such that among patients higher in initial pain intensity, those lower in social-external HLOC experienced higher pain intensity at follow-up compared to those with high social-external HLOC. Internal HLOC and fatalistic-external HLOC did not moderate the effect of initial pain intensity on pain intensity at follow-up.
CONCLUSION: Hand injury patients suffering greater initial pain intensity who also had lower versus higher social-external HLOC experienced less favorable treatment outcome. This finding suggests that if patients with high initial pain succeed in transferring perceived health control to professionals and to gain confidence in treatment and clinicians, treatment outcome could be improved in hand surgery

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 June 2018
Deposited On:07 Mar 2019 15:21
Last Modified:10 Mar 2019 06:51
Publisher:Springer
ISSN:1070-5503
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s12529-018-9713-4
PubMed ID:29488207

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