Catastrophic Thinking and Pain Alleviation After Lower Extremity Surgery
| Autor: | David Ring, David C. Laverty, Matthew D. Driscoll, Carl A Nunziato, Karl M. Koenig, Amirreza Fatehi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cross-sectional study MEDLINE Logistic regression 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Depression (differential diagnoses) Pain Measurement Pain Postoperative 030222 orthopedics business.industry Catastrophization 030208 emergency & critical care medicine General Medicine Evidence-based medicine Cognitive bias Analgesics Opioid Cross-Sectional Studies Lower Extremity Opioid Pill Physical therapy Surgery business medicine.drug |
| Zdroj: | Journal of Orthopaedic Trauma. 35:e89-e95 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000001917 |
| Popis: | Objectives Requests for opioid pain medication more than a few weeks after surgery are associated with greater symptoms of depression and cognitive biases regarding pain such as worst-case thinking and fear of painful movement. We sought factors associated with patient desire for more opioid medication and satisfaction with pain alleviation at suture removal after lower extremity surgery. Design Cross sectional study. Setting Enrollment occurred at 1 of 4 orthopaedic offices in an urban setting. Patients/participants At suture removal after lower extremity surgery, 134 patients completed questionnaires measuring catastrophic thinking, ability to reach goals and continue normal activities in spite of pain, symptoms of depression, and magnitude of physical limitations. Main outcome measurements Psychological factors associated with questionnaire-reported patient desire for another opioid prescription, satisfaction with postoperative pain alleviation, and the self-reported number of pills remaining from original opioid prescription. Results In logistic regression, smoking and greater catastrophic thinking were independently associated with desire for opioid refill (R2 = 0.20). Lower satisfaction with pain alleviation was associated with greater catastrophic thinking (R2 = 0.19). The size of surgery (large vs. medium/small procedure) was not associated with pain alleviation or satisfaction with pain alleviation. Conclusions The association between unhelpful cognitive bias regarding pain and request for more opioids reinforces the importance of diagnosing and addressing common misconceptions regarding pain in efforts to help people get comfortable. Level of evidence Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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