Abstract
Limb reconstruction is an orthopaedic surgical technique designed to restore or improve functioning and appearance. The aims of the present study were to investigate levels of psychological distress in adults undergoing limb reconstruction as a result of traumatic injury, to examine which variables could account for any variations in distress during and after treatment, and to ascertain the potential relevance of psychological interventions. A cross-sectional sample of patients completed measures of psychological distress, posttraumatic symptomatology, coping, social support, pain, and disability. Self-reported levels of psychological distress and posttraumatic symptoms were high but did not tend to vary across stage of treatment, suggesting that distress is not solely attributable to limb reconstruction treatment per se but to other factors. Both medical variables (pain and mobility) and psychological variables (symptoms of trauma and coping strategies) accounted for a significant percentage of the variance in HAD scores. These results suggest that both medical and psychological interventions have potential for reducing distress and increasing well-being in an orthopaedic population who are experiencing high levels of emotional distress.
Similar content being viewed by others
REFERENCES
Binney, V., Bond, J., Shaw, S., & Saleh, M. (***) Psychological aspects of limb lengthening surgery: A comparison of shortstatured and length discrepancy children. Manuscript submitted for publication.
Brewin, C. R., Robson, M. J., & Shapiro, D. A. (1983). Social and psychological determinants of recovery from industrial injuries. Injury, 14, 451–455.
Bulman, R. J., & Wortman, C. B. (1977). Attributions of blame and coping in the “real world”: Severe accident victims react to their lot. Journal of Personality and Social Psychology, 35, 351–363.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically–based approach. Journal of Personality and Social Psychology, 56, 267–283.
Cohen, F., & Lazarus, R. S. (1973). Active coping processes, coping dispositions and recovery from surgery. Psychosomatic Medicine, 35, 375–389.
Contrada, R. J., Leventhal, E. A., & Anderson, J. R. (1994). Psychological preparation for surgery: Marshalling individual and social resources to optimize self–regulation. In S. Maes, H. Leventhal, & M. Johnson (Eds.), International review of health psychology. Chichester, UK: Wiley.
Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology, 107, 508–519.
Feinstein, A., & Dolan, R. (1991). Predictors of posttraumatic stress disorder following physical trauma: An examination of the stressor criterion. Psychological Medicine, 21, 85–91.
Funch, D. P., & Mettlin, C. (1982). The role of support in relation to recovery from breast surgery. Social Science and Medicine, 16, 91–98.
Gatchel, R., & Turk, D. (Eds.) (1996). Psychological approaches to pain management. London: Guildford Press.
Kincey, J., & Saltmore, S. (1990). Surgical treatments. In M. Johnston & L. Wallace (Eds.), Stress and medical procedures. Oxford: Oxford University Press.
Kuch, K., Cox, B. J., Evans, R. J., & Shulman, I. (1994). Phobias, panic, and pain in 55 survivors of road vehicle accidents. Journal of Anxiety Disorders, 8, 181–187.
Kuch, K., Evans, R. J., Watson, P. C., Bubela, C., & Cox, B. J. (1991). Road vehicle accidents and phobias in 60 patients with fibromyalgia. Journal of Anxiety Disorders, 5, 273–280.
Lerner, R. K., Esterhai, J. L., Polomano, R. C., Cheatle, M. D., & Heppenstall, R. B. (1993). Quality of life assessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower–extremity amputation. Clinical Orthopaedics and Related Research, 295, 28–36.
Lerner, R. K., Esterhai, J. L., Polomano, R. C., Cheatle, M. D., Heppenstall, R. B., & Brighton, C. T. (1991). Psychosocial, functional, and quality of life assessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower–extremity amputation. Archives of Physical Medicine and Rehabilitation, 72, 122–126.
Power, M. J., Champion, L. A., & Aris, S. J. (1988). The development of a measure of social support: The Significant Others Scale (SOS). British Journal of Clinical Psychology, 27, 349–358.
Saleh, M., & Burton, M. (1991). Leg lengthening: Patient selection and management in achondroplasia. Orthopedic Clinics of North America, 22, 589–599.
Saleh, M., & Scott, B. W. (1992). Pitfalls and complications in leg lengthening: The Sheffield experience. Seminars in Orthopaedics, 17, 207–222.
Taezner, P., Melzack, R., & Jeans, M. E. (1986). Influence of psychological factors on post–operative pain, mood and analgesic requirements. Pain, 24, 331–342.
Weiss, D. S., & Marmar, C. R. (1995). The Impact of Event Scale–Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD. London: Guilford Press.
Young, N., Bell, D. F., & Anthony, A. (1994). Pediatric pain patterns during Ilizarov treatment of limb length discrepancy and angular deformity. Journal of Pediatric Orthopaedics, 14, 352–357.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Scott, S.R.H., Kent, G. & Rowlands, A. Psychological Distress Reported by Patients Undergoing Limb Reconstruction Surgery: Implications for Psychological Interventions. Journal of Clinical Psychology in Medical Settings 8, 301–305 (2001). https://doi.org/10.1023/A:1011925014988
Issue Date:
DOI: https://doi.org/10.1023/A:1011925014988