The relationship between pain and activity participation, quality of life and depression symptoms in traumatic hand injuries.

Abstract

Objective: This study aimed to investigate the relationship between post-traumatic pain levels in patients with hand-wrist injuries and symptoms of depression, activity participation, and quality of life. Methods: The study included 44 patients who presented to the Physical Therapy and Traumatic Hand Injury Outpatient Clinic with various diagnoses of traumatic hand injuries. Eligible patients had sustained traumatic hand injuries up to 10 cm proximal to the wrist, had no prior diagnosis of depression, and presented to the clinic for the first time between postoperative days 3 and 10. Pain severity was assessed using the Visual Analog Scale (VAS), activity participation was evaluated with the Quick Disability of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), health-related quality of life was measured with the European Quality of Life Five Dimension Five Level Scale (EQ-5D-3L), and depression symptoms were assessed using the Beck's Depression Inventory (BDI). Results: All patients included in the study had at least one injured structure. The majority of the patients were male and worked in blue-collar occupations. The depressive symptoms were classified as moderately severe (BDI score ≥ 17). Among the injured structures, tendon injuries were the most common, and post-traumatic injuries were the most frequently observed type. Visual Analog Scale scores were significantly higher in tendon-fracture and tendon-nerve injuries compared to tendon injuries alone (P=.038 and P < .001, respectively). Quick Disability of the Arm, Shoulder, and Hand Questionnaire scores were significantly higher in tendon-nerve injuries than in tendon injuries (P < .001). Beck's Depression Inventory scores were significantly higher in tendon-nerve injuries than in bone and tendon injuries (P=.006 and P < .001, respectively). European Quality of Life Five Dimension Five Level Scale index scores were significantly lower in tendon-nerve injuries compared to bone and tendon injuries (P=.002 and P < .001, respectively). Correlation analysis revealed that VAS, QuickDASH, and BDI scores were not correlated with age. However, there was a strong positive correlation between VAS and QuickDASH scores, VAS and BDI scores, and QuickDASH and BDI scores. Conclusion: The findings suggest that pain management and psychological support interventions should be integrated into the rehabilitation process for patients with traumatic hand injuries. Addressing both pain and depressive symptoms during recovery may help minimize their negative impact on quality of life and improve activity participation. Level of Evidence: Level IV, Prognostic Study.