Psychological and psychiatric factors related to health-related quality of life after total hip replacement - preliminary report

Total hip replacement is one of the most successful orthopaedic interventions in improving considerably the patients' performance, nevertheless some patients demonstrate declined functional ability following an operation. Such condition is not a consequence of medical illness or the surgery itself but might rather be associated with mental status. The authors conduct an investigation concerning the relation between some psychological and psychiatric factors and their influence on health-related quality of life in patients after total hip replacement. Methods. - Into the study group we included 102 subjects undergoing total hip replacement (59 female, 43 male). In all subjects we measured depression (Beck Depression Inventory - BDI), anxiety (State and Trait Anxiety Inventory - STAI), sense of coherence (SOC-29), personality traits (Eysenck Personality Inventory - EPI) and health related quality of life (SF-36). Results. - The postoperative values of the PCS and the MCS for the whole group of patients correlated negatively with the SOC values (p = 0.04 and p = 0.03 respectively). Neuroticism (EPI) and anxiety as a trait (STAI) were also associated with postoperative performance, both in mental (p = 0.03 and p = 0.008 respectively) and physical (p = 0.005 and p = 0.04 respectively terms). Conclusion. - Total hip replacement improves significantly the patient's health-related quality of life at 6 months after surgery, what is influenced by sense of coherence, neuroticism and anxiety as a trait. Above mentioned factors should be taken into account when rehabilitation and social readaptation processes are planned. (C) 2008 Elsevier Masson SAS. All rights reserved.