The mediating effect of psychological factors on the relationship between pain intensity and wrist joint function: a longitudinal study with mediation analysis.

Abstract:

:Purpose: Psychological factors and pain intensity are associated with wrist function. However, the mediating role of psychological factors in the relationship between pain intensity and wrist function in distal radius fractures remains unclear. We performed mediation analysis to investigate how psychological factors mediate the relationship between pain intensity and wrist function. Methods: Twenty-one patients with distal radius fractures were included in this longitudinal study. Patient-rated wrist evaluation, one pain intensity-related outcome measure (numerical rating scale), and three psychological outcome measures (pain catastrophizing scale, hospital anxiety and depression scale, and pain self-efficacy questionnaire) were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess indirect effects. The level of significance was set at 5%. Results: Mediation analysis showed that the pain intensity, as measured by patient-rated wrist evaluation, had significant indirect effects on the hospital anxiety and depression scale-anxiety (95% bootstrapped confidence interval: 0.96-9.62) and pain self-efficacy questionnaire (95% bootstrapped confidence interval: 0.43-8.11) scores. Conclusions: The relationship between pain intensity and wrist function was mediated by anxiety and self-efficacy. Our findings suggest that interventions focused on psychological factors, particularly anxiety and self-efficacy, may be important in distal radius fractures rehabilitation. IMPLICATIONS FOR REHABILITATION In patients with distal radius fractures, early post-operative pain mediates psychological factors and affects wrist function. Anxiety and self-efficacy are psychological factors that should be noted, and rehabilitation, including self-management, should be considered. Rehabilitative interventions for distal radius fractures should focus on psychological factors and management of post-operative pain.

journal_name

Disabil Rehabil

authors

Hiraga Y,Hisano S,Mizunoe A,Nomiyama K

doi

10.1080/09638288.2019.1676318

subject

Has Abstract

pub_date

2019-10-10 00:00:00

pages

1-5

eissn

0963-8288

issn

1464-5165

pub_type

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