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J Hand Surg Am. 2014 Jul;39(7):1378-1383.e3. doi: 10.1016/j.jhsa.2014.03.042. Epub 2014 May 23.

Patient activation and disability in upper extremity illness.

Author information

  • 1Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA.
  • 2Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA. Electronic address: dring@partners.org.

Abstract

PURPOSE:

To determine if higher patient activation (active involvement in one's health care) correlates with fewer symptoms and less disability in patients with hand and upper extremity illness.

METHODS:

We enrolled 112 patients presenting to our department for the first time. Before meeting with the surgeon, subjects completed a demographics questionnaire, the short form Patient Activation Measure; Quick Disabilities of the Arm, Shoulder, and Hand; Patient Health Questionnaire-2; Pain Self-Efficacy Questionnaire; and an 11-point ordinal rating of pain intensity. We contacted patients 1 to 2 months after enrollment. Seventy-five subjects completed the second evaluation over the telephone, on a secure data-collection web site, or in an office visit, which included the Patient Activation Measure; Quick Disabilities of the Arm, Shoulder, and Hand; numerical rating scale for pain; and ordinal rating of treatment satisfaction.

RESULTS:

Patient activation at enrollment correlated with disability, pain intensity, and satisfaction with treatment but was only retained in the multivariable model for pain intensity. Pain self-efficacy at enrollment was the factor that best accounted for variation in disability, pain, and satisfaction with treatment.

CONCLUSIONS:

Given the consistent relationship between effective coping strategies (eg, pain self-efficacy) and symptoms and disability and the independent influence of patient activation on pain intensity in this study, future research should address the ability of interventions that improve self-efficacy and patient activation to improve upper extremity health.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Prognostic II.

Copyright © 2014 American Society for Surgery of the Hand. All rights reserved.

KEYWORDS:

PAM; Patient activation; disability; self-efficacy; upper extremity

PMID:
24861382
[PubMed - indexed for MEDLINE]
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