Psychosocial health of patients receiving orthopaedic treatment in northern Tanzania: A cross-sectional study.
Global surgery
LMIC
Orthopaedics
Psychosocial health
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
16
07
2019
revised:
15
10
2019
accepted:
24
10
2019
entrez:
6
2
2020
pubmed:
6
2
2020
medline:
6
2
2020
Statut:
epublish
Résumé
Patients with musculoskeletal injuries in Sub-Saharan Africa often receive prolonged inpatient treatment due to limited access to surgical care. Little is known regarding the psychosocial impact of prolonged conservative treatment for orthopaedic injuries, which may add to disability and preclude rehabilitation. A cross-sectional, questionnaire study was conducted to characterize the psychosocial health of orthopaedic inpatients at a tertiary hospital in Moshi, Tanzania. Three validated surveys assessing coping strategies, functional social support, and symptoms of depression were orally administered to all orthopaedic patients with a length of stay (LOS) ≥ 6 days by a Tanzanian orthopaedic specialist. Fifty-nine patient surveys were completed, and revealed 92% (54) of patients were more likely to utilize more adaptive than maladaptive coping strategies. Patients with chest or spinal column injuries were more likely to use maladaptive coping strategies (p = 0·027). Patients with head injuries had more social support compared to others (p = 0·009). Lack of insurance, limited education, and rural origins were associated with less functional social support, although this finding did not reach statistical significance. 23·7% (14) of patients had symptoms consistent with mild depression, 33·9% (20) with moderate depression, and 3·4% (2) with moderately-severe depression. LOS was the only significant predictor for depression severity. 61% (36) of orthopaedic inpatients exhibited depressive symptoms, indicating that the psychosocial health in this population is sub-optimal. Mental health is a crucial element of successful orthopaedic care. Access to timely surgical care would greatly decrease LOS, the most prominent predictor of depressive symptom severity.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with musculoskeletal injuries in Sub-Saharan Africa often receive prolonged inpatient treatment due to limited access to surgical care. Little is known regarding the psychosocial impact of prolonged conservative treatment for orthopaedic injuries, which may add to disability and preclude rehabilitation.
METHODS
METHODS
A cross-sectional, questionnaire study was conducted to characterize the psychosocial health of orthopaedic inpatients at a tertiary hospital in Moshi, Tanzania. Three validated surveys assessing coping strategies, functional social support, and symptoms of depression were orally administered to all orthopaedic patients with a length of stay (LOS) ≥ 6 days by a Tanzanian orthopaedic specialist.
RESULTS
RESULTS
Fifty-nine patient surveys were completed, and revealed 92% (54) of patients were more likely to utilize more adaptive than maladaptive coping strategies. Patients with chest or spinal column injuries were more likely to use maladaptive coping strategies (p = 0·027). Patients with head injuries had more social support compared to others (p = 0·009). Lack of insurance, limited education, and rural origins were associated with less functional social support, although this finding did not reach statistical significance. 23·7% (14) of patients had symptoms consistent with mild depression, 33·9% (20) with moderate depression, and 3·4% (2) with moderately-severe depression. LOS was the only significant predictor for depression severity.
CONCLUSIONS
CONCLUSIONS
61% (36) of orthopaedic inpatients exhibited depressive symptoms, indicating that the psychosocial health in this population is sub-optimal. Mental health is a crucial element of successful orthopaedic care. Access to timely surgical care would greatly decrease LOS, the most prominent predictor of depressive symptom severity.
Identifiants
pubmed: 32021686
doi: 10.1016/j.amsu.2019.10.020
pii: S2049-0801(19)30154-2
pmc: PMC6994630
doi:
Types de publication
Journal Article
Langues
eng
Pagination
49-55Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
There are no conflicts of interest to report.
Références
Int J Behav Med. 1997;4(1):92-100
pubmed: 16250744
J Gen Intern Med. 2009 Feb;24(2):189-97
pubmed: 19031037
J Clin Psychiatry. 2013 Feb;74(2):e137-43
pubmed: 23473359
Pan Afr Med J. 2016 Feb 19;23:46
pubmed: 27217872
J Sport Rehabil. 2018 Jul 25;:1-6
pubmed: 28872439
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
AIDS. 2001 Sep 28;15(14):1865-74
pubmed: 11579250
PLoS One. 2013 Jul 03;8(7):e69088
pubmed: 23844249
Cult Med Psychiatry. 2018 Sep;42(3):483-503
pubmed: 29392517
Issues Ment Health Nurs. 2011;32(12):766-73
pubmed: 22077749
AIDS Care. 2016;28 Suppl 1:140-7
pubmed: 27002772
Int J Psychiatry Med. 2006;36(3):367-81
pubmed: 17236703
J Pers. 1990 Sep;58(3):503-13
pubmed: 2246747
J Pers Soc Psychol. 1989 Feb;56(2):267-83
pubmed: 2926629
BMC Emerg Med. 2017 Oct 13;17(1):30
pubmed: 29029604
Matern Child Health J. 2016 May;20(5):941-5
pubmed: 27010550
Int J Environ Res Public Health. 2010 Jun;7(6):2543-58
pubmed: 20644689
Hand (N Y). 2018 Sep;13(5):529-537
pubmed: 28877603
Curationis. 2013 May 24;36(1):E1-7
pubmed: 23718805
Scand J Trauma Resusc Emerg Med. 2011 Jun 22;19:39
pubmed: 21696614
Med Care. 1988 Jul;26(7):709-23
pubmed: 3393031
Pan Afr Med J. 2015 Dec 04;22:338
pubmed: 26977245
BMC Public Health. 2018 Feb 21;18(1):275
pubmed: 29466975
BMC Psychiatry. 2013 Dec 01;13:324
pubmed: 24289721
Injury. 2017 Sep;48(9):1978-1984
pubmed: 28551050
Ann Glob Health. 2019 Mar 04;85(1):
pubmed: 30873794
Jpn J Clin Oncol. 2013 Jan;43(1):45-54
pubmed: 23166386
PLoS One. 2014 Oct 31;9(10):e110940
pubmed: 25360815