Clinical Orthopaedics and Related Research®最新文献

How Does Shame Relate to Clinical and Psychosocial Outcomes in Knee Osteoarthritis? 羞耻感如何与膝骨关节炎的临床和社会心理结果相关？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2024-12-03 DOI: 10.1097/CORR.0000000000003329

Jia Ying Yeo, Chien Joo Lim, Su-Yin Yang, Bryan Yijia Tan

{"title":"How Does Shame Relate to Clinical and Psychosocial Outcomes in Knee Osteoarthritis?","authors":"Jia Ying Yeo, Chien Joo Lim, Su-Yin Yang, Bryan Yijia Tan","doi":"10.1097/CORR.0000000000003329","DOIUrl":"10.1097/CORR.0000000000003329","url":null,"abstract":"Background: Knee osteoarthritis (OA) is a common and disabling condition that often carries severe psychosocial implications. Chronic illness-related shame has emerged as a substantial psychosocial factor affecting individuals with knee OA, but it is unclear how chronic illness-related shame is associated with the long-term clinical and psychosocial outcomes in individuals with knee OA.Questions/purposes: (1) Does a higher level of shame correlate with worse clinical and psychosocial outcomes at baseline among individuals with knee OA? (2) Is a higher level of shame at baseline associated with worse clinical and psychosocial outcomes at 4-month and 12-month follow-up among individuals with knee OA? (3) Are sociodemographic characteristics correlated with levels of shame among individuals with knee OA?Methods: Between June 2021 and February 2022, we screened 977 patients based on the inclusion criteria of (1) age 45 years or older, (2) independent in community mobility with or without walking aids, (3) proficient in English or Chinese language, and (4) met the clinical criteria for OA diagnosis outlined by the National Institute for Health and Care Excellence. Of these patients, 47% (460) were eligible and enrolled. A further 53% (517) were excluded for prespecified reasons. Of the 460 enrolled patients, 7% (30) dropped out before data collection began, and 46% (210) of patients did not complete the psychological questionnaires, leaving 48% (220) of patients for analysis. From this final sample, 25% (56) were lost to follow-up at 4 months, and an additional 7% (16) were lost by the 12-month follow-up, leaving 67% (148) of the original eligible group for analysis. All patients were recruited from the outpatient clinics of the orthopaedic and physiotherapy departments across two Singapore hospitals within the National Healthcare Group. The study population had a mean ± SD age of 64 ± 8 years, with 69% (152 of 220) women, and the mean ± SD duration of knee OA symptoms was 6 ± 6 years. Outcome measures used were the Chronic Illness-Related Shame Scale (CISS), the 12-item Knee Injury and Osteoarthritis Outcome Score (KOOS-12), Patient Health Questionnaire 4 (PHQ-4), the 8-item Arthritis Self-Efficacy Scale (ASES-8), and the Brief Fear of Movement Scale (BFOM). The CISS is a validated tool specifically designed to measure feelings of shame (internal and external shame) in individuals living with chronic illness. The scale has been validated for use among patients with knee OA in Singapore. The functional outcome measure used was the Modified Barthel Index. Data on demographic characteristics were collected. Data were collected at baseline, 4-month follow-up, and 12-month follow-up. Statistical analyses included the Spearman correlation, linear regression, and cluster analysis.Results: At baseline, there was a weak to moderate negative correlation between CISS sco","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"558-570"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-01-21 DOI: 10.1097/CORR.0000000000003351

Tina A Greenlee, Steven Z George, Bryan Pickens, Daniel I Rhon

{"title":"Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.","authors":"Tina A Greenlee, Steven Z George, Bryan Pickens, Daniel I Rhon","doi":"10.1097/CORR.0000000000003351","DOIUrl":"10.1097/CORR.0000000000003351","url":null,"abstract":"Background: A number of efforts have been made to tailor behavioral healthcare treatments to the variable needs of patients with low back pain (LBP). The most common approach involves the STarT Back Screening Tool (SBST) to triage the need for psychologically informed care, which explores concerns about pain and addresses unhelpful beliefs, attitudes, and behaviors. Such beliefs that pain always signifies injury or tissue damage and that exercise should be avoided have been implied as psychosocial mediators of chronic pain and can impede recovery. The ability of physical therapy interventions guided by baseline stratification for risk of persistent LBP or related functional limitations to improve unhelpful pain beliefs has not been well assessed. Because treatments are aimed at addressing these beliefs, understanding a bit more about the nature of beliefs about pain (for example, attitudes and knowledge) might help us understand how to better tailor this care or even our risk-stratification approaches for future treatment of patients with LBP.Questions/purposes: (1) Did patients assigned to receive risk-stratified care score higher on an assessment of pain science knowledge? (2) Did patients assigned to receive risk-stratified care have fewer unhelpful attitudes related to pain? (3) Did patients assigned to receive risk-stratified care have less pain-associated psychological distress? (4) Regardless of intervention received, is baseline SBST risk category (low, medium, or high) associated with changes in attitudes and knowledge about pain?Methods: This is a secondary analysis of short-term changes in pain beliefs following the 6-week treatment phase of a randomized controlled trial that examined the effectiveness of a risk-stratified physical therapy intervention on pain-related disability at 1 year. Between April 2017 and February 2020, a total of 290 patients in the Military Health System seeking primary care for LBP were enrolled in a trial comparing a behavioral-based intervention to usual care. The intervention involved psychologically informed physical therapy using cognitive behavioral principles and included tailored education, graded exercise, and graded exposure. Individuals assigned to usual care followed treatment plans set forth by their primary care provider. Thirty-one patients were removed from Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool analyses due to missing assessments at 6 weeks (n = 15 intervention; n = 16 usual care). This resulted in 89% (259 of 290) of participants included for secondary analysis, with no difference in baseline demographic characteristics between groups. The usual-care group comprised 50% of the total study group (129 of 259), with a mean age of 34 ± 9 years; 67% (87 of 129) were men. The risk-stratified care group comprised 50% (130 of 259) of the total study group, with a mean ± SD age of 35 ± 8 ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"607-620"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to the Letter to the Editor: Acquired Acromion Compromise, Including Thinning and Fragmentation, Is Not Associated With Poor Outcomes After Reverse Shoulder Arthroplasty.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/CORR.0000000000003435

Su Cheol Kim, Jae Chul Yoo

引用次数: 0

CORR® Curriculum-Orthopaedic Education: How Should Residents Be Using Research Protected Time for Scholarly Activities?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1097/CORR.0000000000003439

Paul J Dougherty

引用次数: 0

Is It Possible to Develop a Patient-reported Experience Measure With Lower Ceiling Effect? 是否有可能开发出上限效应较低的患者报告体验测量方法？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2024-10-25 DOI: 10.1097/CORR.0000000000003262

Niels Brinkman, Rick Looman, Prakash Jayakumar, David Ring, Seung Choi

{"title":"Is It Possible to Develop a Patient-reported Experience Measure With Lower Ceiling Effect?","authors":"Niels Brinkman, Rick Looman, Prakash Jayakumar, David Ring, Seung Choi","doi":"10.1097/CORR.0000000000003262","DOIUrl":"10.1097/CORR.0000000000003262","url":null,"abstract":"Background: Patient-reported experience measures (PREMs), such as the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) or the Wake Forest Trust in Physician Scale (WTPS), have notable intercorrelation and ceiling effects (the proportion of observations with the highest possible score). Information is lost when high ceiling effects occur as there almost certainly is at least some variation among the patients with the highest score that the measurement tool was unable to measure. Efforts to identify and quantify factors associated with diminished patient experience can benefit from a PREM with more variability and a smaller proportion of highest possible scores (that is, a more limited ceiling effect) than occurs with currently available PREMs.Questions/purposes: In the first stage of a two-stage process, using a cohort of patients seeking musculoskeletal specialty care, we asked: (1) What groupings of items that address a similar aspect of patient experience are present among binary items directed at patient experience and derived from commonly used PREMs? (2) Can a small number of representative items provide a measure with potential for less of a ceiling effect (high item difficulty parameters)? In a second, independent cohort enrolled to assess whether the identified items perform consistently among different cohorts, we asked: (3) Does the new PREM perform differently in terms of item groupings (factor structure), and would different subsets of the included items provide the same measurement results (internal consistency) when items are measured using a 5-point rating scale instead of a binary scale? (4) What are the differences in survey properties (for example, ceiling effects) and correlation between the new PREM and commonly used PREMs?Methods: In two cross-sectional studies among patients seeking musculoskeletal specialty care conducted in 2022 and 2023, all English-speaking and English-reading adults (ages 18 to 89 years) without cognitive deficiency were invited to participate in two consecutive, separate cohorts to help develop (the initial, learning cohort) and internally validate (the second, validation cohort) a provisional new PREM. We identified 218 eligible patients for the initial learning cohort, of whom all completed all measures. Participants had a mean ± SD age of 55 ± 16 years, 60% (130) were women, 45% (99) had private insurance, and most sought care for lower extremity (56% [121]) and nontraumatic conditions (63% [137]). We measured 25 items derived from other commonly used PREMs that address aspects of patient experience in which patients reported whether they agreed or disagreed (binary) with certain statements about their clinician. We performed an exploratory factor analysis and confirmatory factor analysis (CFA) to identify groups of items that measure the same underlying construct related to patient experience. We then applied a ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"693-703"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CORR Insights®: Randomized Controlled Trials Studying Nonoperative Treatments of Osteoarthritis Often Use Misleading and Uninformative Control Groups: A Systematic Review. CORR Insights®：研究骨关节炎非手术治疗的随机对照试验经常使用误导性和无信息的对照组：一项系统综述。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2024-11-12 DOI: 10.1097/CORR.0000000000003316

David Cooper Landy

引用次数: 0

CORR Insights®: Do Fellowship-educated Military Orthopaedic Oncologists Who Practice in Military Settings Treat a Sufficient Volume of Patients to Maintain Their Oncologic Expertise?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-02-05 DOI: 10.1097/CORR.0000000000003390

Paul J Dougherty

引用次数: 0

A New Measure of Quantified Social Health Is Associated With Levels of Discomfort, Capability, and Mental and General Health Among Patients Seeking Musculoskeletal Specialty Care.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-02-05 DOI: 10.1097/CORR.0000000000003394

Niels Brinkman, Melle Broekman, Teun Teunis, Seung Choi, David Ring, Prakash Jayakumar

{"title":"A New Measure of Quantified Social Health Is Associated With Levels of Discomfort, Capability, and Mental and General Health Among Patients Seeking Musculoskeletal Specialty Care.","authors":"Niels Brinkman, Melle Broekman, Teun Teunis, Seung Choi, David Ring, Prakash Jayakumar","doi":"10.1097/CORR.0000000000003394","DOIUrl":"10.1097/CORR.0000000000003394","url":null,"abstract":"Background: A better understanding of the correlation between social health and mindsets, comfort, and capability could aid the design of individualized care models. However, currently available social health checklists are relatively lengthy, burdensome, and designed for descriptive screening purposes rather than quantitative assessment for clinical research, patient monitoring, or quality improvement. Alternatives such as area deprivation index are prone to overgeneralization, lack depth in regard to personal circumstances, and evolve rapidly with gentrification. To fill this void, we aimed to identify the underlying themes of social health and develop a new, personalized and quantitative social health measure.Questions/purposes: (1) What underlying themes of social health (factors) among a subset of items derived from available legacy checklists and questionnaires can be identified and quantified using a brief social health measure? (2) How much of the variation in levels of discomfort, capability, general health, feelings of distress, and unhelpful thoughts regarding symptoms is accounted for by quantified social health?Methods: In this two-stage, cross-sectional study among people seeking musculoskeletal specialty care in an urban area in the United States, all English and Spanish literate adults (ages 18 to 89 years) were invited to participate in two separate cohorts to help develop a provisional new measure of quantified social health. In a first stage (December 2021 to August 2022) , 291 patients rated a subset of items derived from commonly used social health checklists and questionnaires (Tool for Health and Resilience in Vulnerable Environments [THRIVE]; Protocol for Responding to and Assessing Patient Assets, Risks and Experiences [PRAPARE]; and Accountable Health Communities Health-Related Social Needs Screening Tool [HRSN]), of whom 95% (275 of 291; 57% women; mean ± SD age 49 ± 16 years; 51% White, 33% Hispanic; 21% Spanish speaking; 38% completed high school or less) completed all items required to perform factor analysis and were included. Given that so few patients decline participation (estimated at < 5%), we did not track them. We then randomly parsed participants into (1) a learning cohort (69% [189 of 275]) used to identify underlying themes of social health and develop a new measure of quantified social health using exploratory and confirmatory factor analysis (CFA), and (2) a validation cohort (31% [86 of 275]) used to test and internally validate the findings on data not used in its development. During the validation process, we found inconsistencies in the correlations of quantified social health with levels of discomfort and capability between the learning and validation cohort that could not be resolved or explained despite various sensitivity analyses. We therefore identified an additional cohort of 356 eligible patients (February 2023 to June 2023) ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"647-663"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on the Fourth Annual I-MESH Symposium: Communicating Complexity in Mental and Social Health.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2025-01-21 DOI: 10.1097/CORR.0000000000003375

Trevor A Lentz, Kate N Jochimsen, David Ring, Prakash Jayakumar, Julia Blackburn

引用次数: 0

CORR Insights®: Are Levels of Loneliness Associated With Levels of Comfort and Capability in Musculoskeletal Illness? CORR Insights®：孤独程度与肌肉骨骼疾病的舒适度和能力水平有关吗？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-04-01 Epub Date: 2024-12-31 DOI: 10.1097/CORR.0000000000003366

Bryan Yijia Tan

引用次数: 0