Sanya Kathuria, “Is Psychological Distress Related to Pat Outcomes in Surgical Repair of Rotator Cuffs?”
Mentors: Elizabeth Liedhegner & Bhagwant Sindhu, Biomedical Sciences
Damage to the rotator cuff causes shoulder pain and can lead to surgical repair, a problem that affects approximately 20% of the population with incidence increasing with age. Furthermore, psychological factors have been found to be key determinants of health and can influence patient reported outcomes undergoing a medical treatment. Thus, this study aims to review measures of psychological distress in the context of rotator cuff repair. Factors that cause psychological distress can be hospitalization, surgical outcomes, recovery period, financial burden, social support and absence from work. A variety of self-assessment measures are currently used to measure psychological distress and outcomes of the musculoskeletal surgeries and repair. However, the sensitivity, reliability and validity of these measures are not well defined. The goal of the review is to understand the current measures of psychological distress and evaluate their ability to predict patient outcomes in rotator cuff repair. After a preliminary literature review, patients experiencing greater distress show inferior results on the Visual Analog Scale (VAS) pain scale and low scores on the American Shoulder and Elbow Surgeons Shoulder Score. It was also found that Distress Questionnaire-5 was a better tool to determine psychological distress than Kessler’s Questionnaire-5. No clinically approved definition for psychological distress and biases linked to self-assessed questionnaires are certain limitations to our study. In our future studies, we plan to employ a survey for psychological distress as well as a biomarker for stress, cortisol, to determine if reduction of both perceived stress and the stress hormone, cortisol, can improve patient outcomes for rotator cuff repair surgery. Furthermore, we propose to enroll patients in a mindfulness program to facilitate a reduction of stress and compare these outcomes to patients undergoing standard of care.
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