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J Hand Microsurg 2022; 14(04): 315-321
DOI: 10.1055/s-0042-1748879
Original Article

Surgeons Attitude toward Psychosocial Aspects of Trapeziometacarpal Osteoarthritis

Janna S. E. Ottenhoff
1   Plastic, Reconstructive, and Hand Surgery Department, University Medical Center Utrecht, Utrecht, the Netherlands
,
David Ring 
2   Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, United States
,
Aebele B. Mink van der Molen
1   Plastic, Reconstructive, and Hand Surgery Department, University Medical Center Utrecht, Utrecht, the Netherlands
,
J. Henk Coert
1   Plastic, Reconstructive, and Hand Surgery Department, University Medical Center Utrecht, Utrecht, the Netherlands
,
Teun Teunis
3   Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
the Science of Variation Group › Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Background There is notable evidence that unhelpful thoughts (symptoms of anxiety and depression) increase symptom intensity among patients with trapeziometacarpal osteoarthritis (TMC OA). Surgeons may or may not be mindful of this line of evidence when interacting with patients. In a survey-based experiment, we randomized surgeons to be prompted about the psychosocial aspects of TMC OA. We aimed to measure the influence of mindfulness of mental health on treatment recommendations and willingness to discuss mental health interventions.

Methods We randomized 121 hand surgeons to read one of two paragraphs: (A) about biomedical treatment options for TMC OA, or (B) about the impact of mental and social aspects on TMC OA. Thereafter, surgeons were asked several questions about their opinions and treatment recommendations.

Results We found that prompting surgeons with information about the psychosocial aspects of TMC OA did not influence their attitudes or treatment recommendations. Most surgeons were willing to offer patients a workbook (92%) or psychologist referral (84%). Among the few surgeons declining to refer, their reasoning was “it would not be of any help” and “stigmatization.”

Conclusion The observation that a paragraph to encourage mindfulness about the psychosocial aspects of TMC OA, which had no influence on surgeon opinions, suggests that awareness may not be a major factor accounting the relatively limited implementation of this evidence in practice to date. Surgeons seem aware of the importance of psychological influence and barriers may include availability, stigma, and a sense of futility. This is a diagnostic study that reflects level of evidence III.

Keywords

osteoarthritis - thumb - surgeons attitude - referral and consultation - psychological distress

Ethical Approval

This study was approved by the Institutional Review Board of the University of Texas at Austin. This study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study has been performed in accordance with relevant regulations of the U.S. Health Insurance Portability and Accountability Act (HIPAA).


Authors' Contributions

J.S.E.O., T.T., and D.R. conceived the study and were involved in protocol development. J.S.E.O., J.H.C., and A.B.M.vdM. were involved in recruiting participants for the study. J.S.E.O. and T.T. contributed to the analysis of the results and prepared the first draft of the manuscript. D.R., J.H.C., and A.B.M.vdM. supervised the study and findings of the work. All authors reviewed and edited the manuscript and approved the final version of the manuscript.


Note

This study was performed at Dell Medical School, The University of Texas, Austin, Texas, United States.


* The Science of Variation Group: https://sites.google.com/site/scienceofvariationgroup/home .


Supplementary Material



Publication History

Article published online:
10 June 2022

© 2022. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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