The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

Miguel C Jansen; Mark J W van der Oest; Nicoline P de Haas; Ruud W Selles PhD; J Michiel Zuidam Md PhD; Hand-Wrist Study Group

doi:10.1016/j.jhsa.2021.04.002

The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

J Hand Surg Am. 2021 Sep;46(9):748-757. doi: 10.1016/j.jhsa.2021.04.002.

Authors

Miguel C Jansen¹, Mark J W van der Oest², Nicoline P de Haas³, Ruud W Selles PhD⁴, J Michiel Zuidam Md PhD⁵; Hand-Wrist Study Group

Collaborators

Hand-Wrist Study Group:
R A M Blomme, B J R Sluijter, D J J C van der Avoort, A Kroeze, J Smit, J Debeij, E T Walbeehm, G M van Couwelaar, Guus M Vermeulen, J P de Schipper, J F M Temming, J H van Uchelen, H L de Boer, K P de Haas, K Harmsen, O T Zöphel, R Feitz, J S Souer, R Koch, S E R Hovius, T M Moojen, X Smit, R van Huis, P Y Pennehouat, K Schoneveld, Y E van Kooij, R M Wouters, P Zagt, F J van Ewijk, J J Veltkamp, A Fink, W A de Ridder, H P Slijper, R W Selles, J T Porsius, J Tsehaie, R Poelstra, M C Jansen, M J W van der Oest, P O Sun, V J M M Schrier, L Hoogendam, J S Teunissen, Jak Dekker, M Jansen-Landheer, M Ter Stege, L S Duraku, G J Halbesma

Affiliations

¹ Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands; Hand and Wrist Center, Xpert Clinic, the Netherlands. Electronic address: m.c.jansen.1@erasmusmc.nl.
² Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands; Hand and Wrist Center, Xpert Clinic, the Netherlands.
³ Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands.
⁴ Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands.
⁵ Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands.

PMID: 34481633
DOI: 10.1016/j.jhsa.2021.04.002

Abstract

Purpose: Although multiple factors influencing return to work after a carpal tunnel release (CTR) have been identified, little is known about the influence of psychological patient factors on return to work. Therefore, this study aimed to identify the psychological factors that play a role in the return to work after a CTR surgery.

Methods: Patients who planned to undergo a CTR were asked to fill out the Brief Illness Perception Questionnaire and the Patient Health Questionnaire before surgery to measure their illness perceptions and mental health status, respectively. Return to work was defined as the time until returning to work for 50% of normal hours and was measured using a questionnaire at 6 weeks, 3 months, and 6 months. To identify associations between nonpsychological and psychological patient factors and the return to work after CTR surgery, a Cox proportional hazards model was constructed.

Results: In total, 615 patients were included in our study. Six months after surgery, 91% of the patients returned to work. For the psychological patient factors, we found that increases of 1 point on the items of worrying about carpal tunnel syndrome and having faith preoperatively in a beneficial effect of the CTR surgery were associated with hazard ratios of 0.92 (95% confidence interval, 0.88-0.96) and 1.10 (95% confidence interval, 1.02-1.19), respectively, for returning to work in the first 6 months after surgery. An increase of 1 point on the depression subscale of the Patient Health Questionnaire was associated with a hazard ratio of 0.88 (95% confidence interval, 0.78-0.99) for returning to work in the first 6 months after surgery.

Conclusions: Our study showed that multiple psychological patient factors are associated with return to work after a CTR surgery. Addressing these psychological factors before surgery might be a low-cost intervention to improve return to work after the CTR surgery.

Type of study/level of evidence: Prognostic II.

Keywords: Carpal tunnel release; carpal tunnel syndrome; hand surgery; psychology; return to work.

MeSH terms

Anxiety
Carpal Tunnel Syndrome* / surgery
Humans
Mental Health
Perception
Return to Work