Examining the association of functional status, mental health, and pain severity in post-surgical patients
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Citation
Abstract
BACKGROUND:Chronic pain, including chronic post-surgical pain (CPSP), is a serious condition that results in significant harm to the quality of life of a patient. Previous research has demonstrated predictive markers for the development of post-surgical pain which include anxiety, depression, and greater pre-surgical functional impairment. However, minimal research has been done to evaluate whether changes in the status of those markers correspond with changes in post-surgical chronic pain rates at greater time intervals beyond the surgical procedure. This study seeks to evaluate whether the current status of markers such as physical functioning and mental health status correspond to ongoing pain severity in post-surgical patients.
METHODS: Information from 37 participants living in or near Boston, Massachusetts was selected from a larger NIH funded investigation focused on elucidating the biobehavioral mechanisms contributing to CPSP across the lifespan, which began data collection in 2022. Physical functioning was assessed using a 1-minute Sit-to-Stand protocol. Mental health questionnaires including the PROMIS Anxiety Short Form, PROMIS Depression Short Form, and Pain Catastrophizing Scale were completed by each participant. Pain levels were assessed through several measures including the PROMIS Pain Interference Short Form, days of pain per month, and base pain rating at the start of the visit. Spearman and Pearson correlations were calculated to analyze associations between different measures. Additionally, bivariate statistical analysis was used to analyze between-group differences in the study measures.
RESULTS: The Sit-To-Stand testing showed minimal significant correlations with other measures studied. Pain Interference was associated with worse symptom management and increased depression, anxiety, and pain catastrophizing scores. Older adults were found to have completed fewer Sit-to-Stand repetitions and were less likely to have high anxiety levels. High anxiety patients were found to have higher depression and pain catastrophizing scores.
CONCLUSIONS: Performance on the Sit-to-Stand measure did not correspond with pain severity, mental health status, or surgical type. This finding differs from previous studies that have evaluated pre-operative performance on the Sit-to-Stand with post-operative outcomes. This difference may indicate a decreased accuracy or utility in the Sit-To-Stand procedure in post-operative populations. Mental health measures like anxiety, depression, and pain catastrophizing were found to have significant correlations with various pain measures and should continue to be evaluated in this population to better inform and tailor treatment.
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2024