Effects of psychological and spiritual factors on functional recovery and life quality after total knee arthroplasty

HE Ming; ZHU Jin-yu; WANG Ren; ZHONG Xiao-peng; ZHU Qing-sheng

doi:10.3969/j.issn.2095-252X.2014.06.007

Abstract：Objective To study the changes of psychological and spiritual factors before and after total knee arthroplasty ( TKA ) and their effects on knee functional recovery and health-related quality of life.Methods A research on 62 patients who underwent unilateral TKA was performed preoperatively and at 1 and 6 months after the operation, including 37 females and 25 males. The test items included Beck Anxiety Inventory ( BAI ) and Beck Depression Inventory ( BDI ), State Anxiety Inventory ( S-AI ) and Trait Anxiety Inventory ( T-AI ), Eysenck Personality Questionnaire-Revised, Short Scale for Chinese ( EPQ-RSC ), Knee Society Knee Scoring System (KSS), and health-related quality of life questionnaire ( the short-form-36 [ SF-36 ] ).Results There were statistically signiifcant differences in the anxiety degree, depression degree and KSS score at 1 and 6 months after the operation and preoperatively (P<0.01 ). The increasing rates of various indexes of SF-36 were different before and after the operation. Statistical significance existed in the differences between neuroticism in EPQ and the preoperative and postoperative physical health (P=0.001 &P<0.001 ) and the differences between neuroticism in EPQ and the preoperative and postoperative mental health (P<0.001 &P<0.001 ). The iftting degree of the preoperative KSS scores and the postoperative KSS scores and preoperative psychology-related scores was not good (r2=0.12 &r2=0.25 ). A negative correlation existed between the KSS scores at 6 months after the operation and TAI and between the KSS scores at 6 months after the operation and neuroticism in EPQ (P<0.05, B=-0.32 &P<0.001, B=-0.54 ). A positive correlation existed between the KSS scores at 6 months after the operation and extraversion-introversion in EPQ (P<0.05, B=0.32 ).Conclusions Knee function is adequately restored and health-related quality of life is signiifcantly improved, when the patients undergo unilateral TKA at 1 and 6 months after the operation. There are certain effects of psychological and spiritual factors on functional recovery after TKA, and the patients with low degrees of anxiety and depression have better recovery. And meanwhile, appropriate intervention measures should be taken before the operation for the patients with high degrees of anxiety and depression, so as to achieve satisfactory curative effects.