Tuesday, September 15, 2020

"Resiliency" - how does it correlate with clinical outcomes of shoulder surgery?

 Resiliency Influences Post-Operative Outcomes Following Rotator Cuff Repair

These authors attempted to assess the effects of resiliency on postoperative outcome scores and complications in 49 patients four years after rotator cuff repair (RCR).

These patients were monitored for American Shoulder and Elbow Surgeons score (ASES), Simple Shoulder Test (SST), and Life Orientation Test-Revised (LOT-R). 


Please be as honest and accurate as you can throughout. Try not to let your response to one statement influence your responses to other statements. There are no "correct" or "incorrect" answers. Answer according to your own feelings, rather than how you think "most people" would answer.

A = I agree a lot
B = I agree a little
C = I neither agree nor disagree 

D = I disagree a little

E = I disagree a lot

1. In uncertain times, I usually expect the best. 

[2. It's easy for me to relax.]
3. If something can go wrong for me, it will. 

4. I'm always optimistic about my future.

[5. I enjoy my friends a lot.]
[6. It's important for me to keep busy.]
7. I hardly ever expect things to go my way.
[8. I don't get upset too easily.]
9. I rarely count on good things happening to me.
10. Overall, I expect more good things to happen to me than bad.

Note: Items 2, 5, 6, and 8 are fillers and not scored. Responses to "scored" items are to be coded so that high values imply optimism.

There was a statistically significant difference between cohorts and their scores of resiliency and optimism, measured by LOT-R (ASESf, p=0.048; ASESp, p=0.003; SST, p=0.009).

LOT-R scores exhibited a significant impact on outcome scores (ASESf, p=0.043; ASESp, p=0.002; SST, p=0.007). 

Correlational analysis indicated that LOT-R directly correlated with higher ASESp,ASESf, and SST scores (ASESf p=0.029, ASESp p=0.003, SST p=0.018). 

Comment: This study reminds us that the degree of optimism and resilience that the patient brings to surgery correlates with the outcome. 

It is interesting to contemplate whether optimism and resilience can be improved by preoperative coaching and education.


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