The Current Status And Influencing Factors Of Preoperative Pain Catastrophizing In Patients Undergoing Total Keen Arthroplasty

ObjectiveTo describe the status of preoperative pain catastrophizing and specific dimensions among patients undergoing total knee arthroplasty,and to explore the influencing factors of preoperative pain catastrophizing and specific dimensions in patients undergoing total knee arthroplasty and to provide a basis for scientific,individualized and most cost-effective interventions for preoperative pain catastrophizing in patients undergoing total knee arthroplasty.MethodsFrom July 20 to November 20,2020,a cross-sectional survey research method in the descriptive study was carried out in Two tertiary A hospitals in Lanzhou City,Gansu Province.Using convenience sampling method,a total of 360 patients undergoing total knee replacement,in accordance with the unified inclusion and exclusion criteria,were investigated with survey tools including general questionnaires,Pain Catastrophizing Scale(PCS),Quality of Life Questionnaire(SF-36),Oxford Knee Score(OKS),Pain Digital Assessment Method(NRS),General Hospital Anxiety and Depression Scale(HADS),and a revised version of the Life Orientation Test(LOT-R).SPSS 25.0 was used for statistical analysis of the data,and statistical methods included descriptive analysis,Pearson correlation analysis,and multiple stepwise regression analysis.Results(1)The average score of preoperative pain catastrophizing among patients undergoing total knee replacement was 24.92±12.38,the average score of ruminant dimension was 9.00±4.04,the average score for exaggerated dimensions was5.08±2.91,the average score for the helplessness dimension was 10.83±6.31.The incidence of preoperative pain catastrophe was 19.4% when the total score in the pain catastrophe scale was ≥38 as the clinically relevant "critical value".(2)Univariate analysis showed that gender,level of education,marital status,home address,current salary status,medical insurance,age,physical function,Oxford knee score,keen pain during rest and activity,anxiety and depression were related to one or more dimensions of pain catastrophizing,the difference was statistically significant(P < 0.05).(3)The results of multi-factor analysis showed that the main factors influencing preoperative pain catastrophizing of patients undergoing total knee arthroplasty were anxiety,education,physical function and knee pain during activity,which accounted for 51.2%(F=95.149,P<0.01)of the total variation;the main factors influencing ruminant dimension of preoperative pain catastrophizing in patients undergoing total knee arthroplasty were anxiety,education level,knee pain during activity,health and daily activity status and home address,which explained 40.9%(F=50.713,P<0.01)of the total variation;the main factors affecting exaggerated dimension of preoperative pain catastrophizing in patients undergoing total knee arthroplasty were anxiety,level of education and physical function,which explained 46.3%(F=104.343,P<0.01)of the total variation;the main factors influencing helplessness dimension of preoperative pain catastrophizing in patients undergoing total knee arthroplasty were anxiety,physical function,level of education,and knee pain during activity,which together explained 46.9%(F=80.366,P<0.01)of the total variation.Conclusion(1)The study indicate a high prevalence of preoperative pain catastrophizing in patients undergoing total knee arthroplasty,which is mainly manifested as the patients persistently pay too much attention to the pain experience before surgery.(2)The main influencing factors are anxiety,physical function,level of education and knee pain during activity.In addition,home address is also the main influence factors to ruminate dimensions.It suggests that medical staff should timely assess pain catastrophizing in patients undergoing total knee arthroplasty,focus on patients from the countryside,women,low level of education,physical inactivity,knee pain of patients obviously,timely assess anxiety and depression of patients and provide scientific,individualized and most cost-effective intervention measures matching specific dimensions,so as to help patients undergoing total knee arthroplasty improve preoperative pain catastrophizing status.