Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-01-2017 | Research

Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study

Authors: Espen Andreas Brembo, Heidi Kapstad, Sandra Van Dulmen, Hilde Eide

Published in: Health and Quality of Life Outcomes | Issue 1/2017

Abstract

Background

Despite the overall success of total hip replacement (THR) in patients with symptomatic osteoarthritis (OA), up to one-quarter of patients report suboptimal recovery. The aim of this study was to determine whether social support and general self-efficacy predict variability in short-term recovery in a Norwegian cohort.

Methods

We performed secondary analysis of a prospective multicenter study of 223 patients who underwent THR for OA in 2003–2004. The total score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3 months after surgery was used as the recovery variable. We measured self-efficacy using the General Self-Efficacy Scale (GSES) and social support with the Social Provisions Scale (SPS). Preoperative and postoperative scores were compared using Wilcoxon tests. The Mann–Whitney U test compared scores between groups that differed in gender and age. Spearman’s rho correlation coefficients were used to evaluate associations between selected predictor variables and the recovery variable. We performed univariate and multiple linear regression analyses to identify independent variables and their ability to predict short-term recovery after THR.

Results

The median preoperative WOMAC score was 58.3 before and 23.9 after surgery. The mean absolute change was 31.9 (standard deviation [SD] 17.0) and the mean relative change was 54.8% (SD 26.6). Older age, female gender, higher educational level, number of comorbidities, baseline WOMAC score, self-efficacy, and three of six individual provisions correlated significantly with short-term recovery after THR and predicted the variability in recovery in the univariate regression model. In multiple regression models, baseline WOMAC was the most consistent predictor of short-term recovery: a higher preoperative WOMAC score predicted worse short-term recovery (β = 0.44 [0.29, 0.59]). Higher self-efficacy predicted better recovery (β = −0.44 [−0.87, −0.02]). Reliable alliance was a significant predictor of improved recovery (β = −1.40 [−2.81, 0.01]).

Conclusions

OA patients’ general self-efficacy and the expectation of others’ tangible assistance predict recovery after THR. Researchers and clinicians should target these psychosocial factors together with the patients and their families to improve the quality of care and surgical outcomes.

Available only for authorised users

Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthr Cart. 2013;21:1145–53. http://dx.doi.org/10.1016/j.joca.2013.03.018.CrossRef

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96. doi:10.1016/S0140-6736(12)61729-2.CrossRefPubMed

Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:1323–30. doi:10.1136/annrheumdis-2013-204763.CrossRefPubMed

Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005;64:669–81. doi:10.1136/ard.2004.028886.CrossRefPubMed

Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cart. 2008;16:137–62. doi:10.1016/j.joca.2007.12.013.CrossRef

Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86-A:963–74.CrossRefPubMed

NRL. The Norwegian Arthroplasty Register, Report 2015. 2015. http://nrlweb.ihelse.net/Rapporter/Rapport2015.pdf. Accessed 02 Dec 2015.

Shan L, Shan B, Graham D, Saxena A. Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthr Cart. 2014;22:389–406. http://dx.doi.org/10.1016/j.joca.2013.12.006.CrossRef

Fevang B-TS, Lie SA, Havelin LI, Engesæter LB, Furnes O. Improved results of primary total hip replacement. Acta Orthop. 2010;81:649–59. doi:10.3109/17453674.2010.537807.CrossRefPubMedPubMedCentral

10.

Judge A, Cooper C, Williams S, Dreinhoefer K, Dieppe P. Patient-reported outcomes one year after primary hip replacement in a European Collaborative Cohort. Arthritis Care Res. 2010;62:480–8. doi:10.1002/acr.20038.CrossRef

11.

Hawker GA, Badley EM, Borkhoff CM, Croxford R, Davis AM, Dunn S, et al. Which patients are most likely to benefit from total joint arthroplasty? Arthritis Rheum. 2013;65:1243–52. doi:10.1002/art.37901.CrossRefPubMed

12.

Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2:e000435. doi:10.1136/bmjopen-2011-000435.CrossRefPubMedPubMedCentral

13.

Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–8. doi:10.1002/1529-0131(199908)42:8<1722::AID-ANR22>3.0.CO;2-R.CrossRefPubMed

14.

Holtzman J, Saleh K, Kane R. Effect of baseline functional status and pain on outcomes of total hip arthroplasty. J Bone Joint Surg Am. 2002;84-A:1942–8.CrossRefPubMed

15.

Hoogeboom TJ, Dronkers JJ, Hulzebos EH, van Meeteren NL. Merits of exercise therapy before and after major surgery. Curr Opin Anaesthesiol. 2014;27:161–6. doi:10.1097/ACO.0000000000000062.CrossRefPubMedPubMedCentral

16.

Fortin PR, Penrod JR, Clarke AE, St Pierre Y, Joseph L, Belisle P, et al. Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee. Arthritis Rheum 2002;46; doi: 10.1002/art.10631.

17.

Keefe FJ, Smith SJ, Buffington AL, Gibson J, Studts JL, Caldwell DS. Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. J Consult Clin Psychol. 2002;70:640–55.CrossRefPubMed

18.

Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215. doi:10.1037/0033-295X.84.2.191.CrossRefPubMed

19.

Jerusalem M, Schwarzer R. Self-efficacy as a resource factor in stress appraisal processes. In: Schwarzer R, editor. Self-efficacy: thought control of action. Washington: Hemisphere Publishing Corporation; 1992. p. 195–213.

20.

Weinberger M, Tierney WM, Booher P, Hiner SL. Social support, stress and functional status in patients with osteoarthritis. Soc Sci Med. 1990;30:503–8. http://dx.doi.org/10.1016/0277-9536(90)90353-T.CrossRefPubMed

21.

Kapstad H. Pain and health status in patients with osteoarthritis of the hip or knee undergoing joint replacement surgery: measurement issues and outcomes. PhD thesis. Bergen: University of Bergen; 2010.

22.

Kapstad H, Rustøen T, Hanestad BR, Moum T, Langeland N, Stavem K. Changes in pain, stiffness and physical function in patients with osteoarthritis waiting for hip or knee joint replacement surgery. Osteoarthr Cart. 2007;15:837–43. http://dx.doi.org/10.1016/j.joca.2007.01.015.CrossRef

23.

Kapstad H, Hanestad BR, Langeland N, Rustøen T, Stavem K. Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery. BMC Musculoskelet Disord. 2008;9:55. doi:10.1186/1471-2474-9-55.CrossRefPubMedPubMedCentral

24.

Kapstad H, Rokne B, Stavem K. Psychometric properties of the Brief Pain Inventory among patients with osteoarthritis undergoing total hip replacement surgery. Health Qual Life Outcomes 2010;8; doi: 10.1186/1477-7525-8-148.

25.

Bellamy N. WOMAC Osteoarthritis Index User Guide. Version V. Brisbane, Australia. 2002.

26.

Schwarzer R, Jerusalem M, et al. Generalized Self-Efficacy Scale. In: Measures in health psychology: a user’s portfolio. Causal and control beliefs. Windsor, UK: NFER-NELSON; 1995. p. 35–7.

27.

Cutrona CE, Russell DW. The provisions of social relationships and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in personal relationships, vol. 1. Greenwich, CT: JAI Press; 1987. p. 37–67.

28.

Bellamy N, Buchanan W, Goldsmith C, Campbell J, Stitt L. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–40.PubMed

29.

Scholz U, Doña BG, Sud S, Schwarzer R. Is general self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess. 2002;18:242–51. doi:10.1027//1015-5759.18.3.242.CrossRef

30.

Røysamb E, Schwarzer R, Jerusalem M. Norwegian version of the general perceived self-efficacy scale. 1998. http://userpage.fu-berlin.de/~health/norway.htm. Accessed 12 Oct 2015.

31.

Schwarzer R. Everything you wanted to know about the General Self-Efficacy Scale but were afraid to ask. 2014. http://userpage.fu-berlin.de/~health/faq_gse.pdf. Accessed 26 May 2016.

32.

Weiss RS. The provisions of social relationships. In: Rubin Z, editor. Doing unto others: Joining, molding, conforming, helping, loving. Englewood Cliffs, N.J.: Prentice-Hall; 1974. p. 17–26.

33.

Cutrona C, Russell D, Rose J. Social support and adaptation to stress by the elderly. Psychol Aging. 1986;1:47–54.CrossRefPubMed

34.

IBM Corp. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp; 2015.

35.

de Vries H, Kremers SP, Smeets T, Brug J, Eijmael K. The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. Am J Health Promot. 2008;22:417–25. doi:10.4278/ajhp.22.6.417.CrossRefPubMed

36.

Bandura A. Self-efficacy: The exercise of control. New York, NY: W H Freeman/Times Books/ Henry Holt & Co; 1997.

37.

Maddux JE, et al. Self-efficacy: the power of believing you can. In: Snyder CR, Lopez SJ, editors. Handbook of positive psychology. Oxford; New York: Oxford University Press; 2002. p. 277–87.

38.

Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum. 1989;32:37–44.CrossRefPubMed

39.

Brembo EA, Kapstad H, Eide T, Månsson L, Van Dulmen S, Eide H. Patient information and emotional needs across the hip osteoarthritis continuum: a qualitative study. BMC Health Serv Res. 2016;16:1–15. doi:10.1186/s12913-016-1342-5.CrossRef

40.

Ayers DC, Franklin PD, Ring DC. The role of emotional health in functional outcomes after orthopaedic surgery: extending the biopsychosocial model to orthopaedics: AOA critical issues. J Bone Joint Surg Am. 2013;95:e165. doi:10.2106/JBJS.L.00799.CrossRefPubMedPubMedCentral

41.

Lopez-Olivo MA, Landon GC, Siff SJ, Edelstein D, Pak C, Kallen MA, et al. Psychosocial determinants of outcomes in knee replacement. Ann Rheum Dis. 2011;70:1775–81. doi:10.1136/ard.2010.146423.CrossRefPubMed

42.

Escobar A, Quintana JM, Bilbao A, Azkarate J, Guenaga JI, Arenaza JC, et al. Effect of patient characteristics on reported outcomes after total knee replacement. Rheumatology (Oxford). 2007;46:112–9. doi:10.1093/rheumatology/kel184.CrossRef

43.

Fitzgerald JD, Orav EJ, Lee TH, Marcantonio ER, Poss R, Goldman L, et al. Patient quality of life during the 12 months following joint replacement surgery. Arthritis Rheum. 2004;51:100–9. doi:10.1002/art.20090.CrossRefPubMed

44.

McHugh GA, Campbell M, Luker KA. Predictors of outcomes of recovery following total hip replacement surgery: A prospective study. Bone Joint Res. 2013;2:248–54. doi:10.1302/2046-3758.211.2000206.CrossRefPubMedPubMedCentral

45.

van den Akker-Scheek I, Stevens M, Groothoff JW, Bulstra SK, Zijlstra W. Preoperative or postoperative self-efficacy: which is a better predictor of outcome after total hip or knee arthroplasty? Patient Educ Couns. 2007;66:92–9. doi:10.1016/j.pec.2006.10.012.CrossRefPubMed

46.

Wylde V, Dixon S, Blom AW. The Role of Preoperative Self-Efficacy in Predicting Outcome after Total Knee Replacement. Musculoskeletal Care. 2012;10:110–8. doi:10.1002/msc.1008.CrossRefPubMed

47.

Magklara E, Burton CR, Morrison V. Does self-efficacy influence recovery and well-being in osteoarthritis patients undergoing joint replacement? A systematic review. Clin Rehabil. 2014;28:835–46. doi:10.1177/0269215514527843.CrossRefPubMed

48.

Buirs LD, Van Beers LW, Scholtes VA, Pastoors T, Sprague S, Poolman RW. Predictors of physical functioning after total hip arthroplasty: a systematic review. BMJ Open. 2016;6:e010725. doi:10.1136/bmjopen-2015-010725.CrossRefPubMedPubMedCentral

49.

Hofstede SN, Gademan MGJ, Vliet Vlieland TPM, Nelissen RGHH, Marang-van de Mheen PJ. Preoperative predictors for outcomes after total hip replacement in patients with osteoarthritis: a systematic review. BMC Musculoskelet Disord. 2016;17:1–11. doi:10.1186/s12891-016-1070-3.CrossRef

50.

de Groot V, Beckerman H, Lankhorst GJ, Bouter LM. How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003;56:221–9.CrossRefPubMed

51.

Gordon M, Frumento P, Sköldenberg O, Greene M, Garellick G, Rolfson O. Women in Charnley class C fail to improve in mobility to a higher degree after total hip replacement. Acta Orthop. 2014;85:335–41. doi:10.3109/17453674.2014.931199.CrossRefPubMedPubMedCentral

52.

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4. doi:10.1001/jama.2013.281053.CrossRef

Title: Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study
Authors: Espen Andreas Brembo
Heidi Kapstad
Sandra Van Dulmen
Hilde Eide
Publication date: 01-01-2017
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-017-0649-1

At a glance: The STEP trials

Springer Medicine

Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Exploring the factor structure of the Health of the Nation Outcomes Scale (HoNOS) in a sample of patients with schizophrenia, schizotypal and delusional disorders

Determining the longitudinal validity and meaningful differences in HRQL of the PedsQL™ Sickle Cell Disease Module

Decreased physical activity is a predictor for a complicated recovery post cardiac surgery

Item analysis using Rasch models confirms that the Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules are valid and reliable

Employment status and health related quality of life among Hodgkin-lymphoma survivors’– results based on data from a major treatment center in Hungary

Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis