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|Title: ||The importance of self-rated health and mental well-being in predicting health outcomes following total joint replacement surgery for osteoarthritis|
|Authors: ||Perruccio, AV|
|Keywords: ||The importance of self-rated health and mental well-being in predicting health outcomes following total joint replacement surgery for osteoarthritis|
|Issue Date: ||Jul-2011|
|Publisher: ||Arthritis Care and Research|
|Citation: ||. Arthritis Care and Research, 2011 Jul;63(7):973-981|
|Abstract: ||Objective: Studies of the determinants, and the scope of outcomes examined, in patient-reported
total joint replacement (TJR) outcomes have typically been limited to aspects of physical health.
We investigated mental well-being, physical and social health and self-rated health (SRH) as
predictors of future health status within a cohort undergoing a TJR for hip or knee osteoarthritis.
We also investigated the inter-relationships among these health dimensions as they relate to
Methods: Participants (215 hip; 234 knee) completed measures pre-surgery and 3 and 6 months
post-surgery: pain, physical function, fatigue, anxiety, depression, social participation
limitations, passive/active recreation, and community mobility. Structural equation modeling was
used to investigate the inter-relationship between the latent health dimensions (physical, mental,
social) and the predictive significance of SRH for future health status.
Results: Mean age: 63.5 years (range: 31, 88); 60% female. Prior dimension status strongly
predicted future status. Adjusted for prior dimension scores, comorbidity and sociodemographic
characteristics, SRH predicted future scores for all three health dimensions. Worse prior SRH
predicted less improvement at all time-points. The effects of physical and social health on SRH
were fully mediated through mental well-being. Only mental well-being significantly predicted
SRH, within and across time.
Conclusion: Mental well-being is critical for understanding the relationship between physical
health and SRH. In addition SRH significantly predicts TJR outcomes, above and beyond prior
physical health. The exclusive focus on any one health dimension may lead to missed
opportunities for predicting and improving outcomes following surgery, and likely improving
overall health generally.|
|Appears in Collections:||UofT Faculty publications|
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