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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/29583

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
Davis, AM
Hogg-Johnson, S
Badley, EM
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 SRH. 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.
URI: http://hdl.handle.net/1807/29583
Appears in Collections:UofT Faculty publications

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