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The Role of Health Locus of Control in Pain Intensity Outcome of Conservatively and Operatively Treated Hand Surgery Patients

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Abstract

Purpose

Psychological factors have shown to be associated with treatment outcomes in hand injury patients. This study aimed to investigate the role of health locus of control (HLOC) and its dimensions internal, social-external, and fatalistic-external HLOC in treatment outcomes of hand injury patients.

Method

One hundred thirty-two consecutive patients of a tertiary center for hand surgery undergoing treatment for acute hand injury or degenerative hand problems were included in this study. Pretreatment levels of depression, anxiety, HLOC, and pain intensity were measured, along with pain intensity levels at 4-month follow-up. Hierarchical regression analyses were calculated to test for moderation effects of the HLOC dimensions on the relationship between pretreatment and follow-up pain intensity.

Results

Controlling for age, gender, treatment modality, source of hand pain, and depressive symptoms, a moderation effect emerged (β = − 0.16, p < 0.05), such that among patients higher in initial pain intensity, those lower in social-external HLOC experienced higher pain intensity at follow-up compared to those with high social-external HLOC. Internal HLOC and fatalistic-external HLOC did not moderate the effect of initial pain intensity on pain intensity at follow-up.

Conclusion

Hand injury patients suffering greater initial pain intensity who also had lower versus higher social-external HLOC experienced less favorable treatment outcome. This finding suggests that if patients with high initial pain succeed in transferring perceived health control to professionals and to gain confidence in treatment and clinicians, treatment outcome could be improved in hand surgery.

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Authors and Affiliations

  1. Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, 3010, Bern, Switzerland

    Julian A. Stewart, Niklaus Egloff, Barbara Wegmann & Martin grosse Holtforth

  2. Department of Psychology, University of Bern, Bern, Switzerland

    Julian A. Stewart, Vera Aebischer & Martin grosse Holtforth

  3. Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland

    Roland von Känel

  4. Department of BioMedical Research, University of Bern, Bern, Switzerland

    Niklaus Egloff, Roland von Känel & Esther Vögelin

  5. Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, Bern, Switzerland

    Esther Vögelin

Authors
  1. Julian A. Stewart
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  2. Vera Aebischer
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  3. Niklaus Egloff
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  4. Barbara Wegmann
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  5. Roland von Känel
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  6. Esther Vögelin
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  7. Martin grosse Holtforth
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Correspondence to Julian A. Stewart.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Stewart, J.A., Aebischer, V., Egloff, N. et al. The Role of Health Locus of Control in Pain Intensity Outcome of Conservatively and Operatively Treated Hand Surgery Patients. Int.J. Behav. Med. 25, 374–379 (2018). https://doi.org/10.1007/s12529-018-9713-4

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  • DOI: https://doi.org/10.1007/s12529-018-9713-4

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