The Correlation of Cognitive Flexibility with Pain Intensity and Magnitude of Disability in Upper Extremity Illness

Journal of Hand and Microsurgery

David Ring¹  Jan Paul Briet¹  Ana-Maria Vranceanu¹  Arjan G. Bot¹  Thijs C.H. Oosterhoff¹  Michiel G.J.S. Hageman¹ 

[1] Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA 02114 USA

关键词: Cognitive flexibility scale;    Pain intensity;    Disability;    Upper extremity;    Self-efficacy;   

DOI  :  10.1007/s12593-014-0140-8

学科分类：外科医学

来源: Thieme Medical and Scientific Publishers Pvt. Ltd.

【 摘 要 】

Cognitive flexibility – the ability to restructure one’s knowledge, incorporate new facts, widen perspective, and adapt to the demands of new and unexpected conditions - can help one adapt to illness. The aim of this study was to assess the relationship between cognitive flexibility and hand and upper extremity specific disability in patients presenting to a hand surgeon. Secondarily, we determined predictors of cognitive flexibility and pain. Eighty-nine consecutive outpatients completed the Cognitive flexibility questionnaire (CFS), Short Health Anxiety Inventory-5 (SHAI-5), Pain Self-Efficacy Questionnaire (PSEQ), Disabilities of Arm, Shoulder and Hand, short form (QuickDASH), and Patient Health Questionnaire for Depression-2 (PHQ-2) in a cross-sectional study. CFS did not correlate with disability or pain intensity. Disability correlated with PSEQ (r = −0.66, p < 0.01), PHQ-2 (r = 0.38, p = <0.01), and SHAI-5 (r = 0.33, p < 0.01). Pain intensity correlated with PSEQ (r = −0.51 p < 0.01) and PHQ-2 (r = 0.41 p < 0.01). There was a small correlation between the CFS and PSEQ (r = 0.25, p = 0.02). The best multivariable models for QuickDASH and pain intensity included PSEQ and PHQ and explained 35 % and 28 % of the variability respectively. Upper extremity specific disability and pain intensity are limited more by self-efficacy than cognitive flexibility. Interventions to improve self-efficacy might help patients with upper extremity illness.

【 授权许可】

Unknown