The Correlation of Cognitive Flexibility with Pain Intensity and Magnitude of Disability in Upper Extremity Illness

Michiel G.J.S. Hageman; Jan Paul Briet; Thijs C.H. Oosterhoff; Arjan G. Bot; David Ring; Ana-Maria Vranceanu

doi:10.1007/s12593-014-0140-8

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2014; 06(02): 59-64
DOI: 10.1007/s12593-014-0140-8

Original Article

Thieme Medical and Scientific Publishers Private Ltd.

The Correlation of Cognitive Flexibility with Pain Intensity and Magnitude of Disability in Upper Extremity Illness

Michiel G.J.S. Hageman

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

,

Jan Paul Briet

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

,

Thijs C.H. Oosterhoff

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

,

Arjan G. Bot

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

,

David Ring

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

,

Ana-Maria Vranceanu

¹Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA Email: mghageman@partners.org Email: jp.briet@gmail.com Email: tch.oosterhoff@gmail.com Email: a.g.j.bot@gmail.com Email: dring@partners.org

²Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA Email: avranceanu@partners.org

› Author Affiliations
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Abstract

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Abstract

Cognitive flexibility – the ability to restructure one’s knowledge, incorporate new facts, widen perspective, and adapt to the demands of new and unexpected conditions – can help one adapt to illness. The aim of this study was to assess the relationship between cognitive flexibility and hand and upper extremity specific disability in patients presenting to a hand surgeon. Secondarily, we determined predictors of cognitive flexibility and pain. Eighty-nine consecutive outpatients completed the Cognitive flexibility questionnaire (CFS), Short Health Anxiety Inventory-5 (SHAI-5), Pain Self-Efficacy Questionnaire (PSEQ), Disabilities of Arm, Shoulder and Hand, short form (QuickDASH), and Patient Health Questionnaire for Depression-2 (PHQ-2) in a cross-sectional study. CFS did not correlate with disability or pain intensity. Disability correlated with PSEQ (r=–0.66, p<0.01), PHQ-2 (r=0.38, p=<0.01), and SHAI-5 (r=0.33, p<0.01). Pain intensity correlated with PSEQ (r=–0.51 p<0.01) and PHQ-2 (r=0.41 p<0.01). There was a small correlation between the CFS and PSEQ (r=0.25, p=0.02). The best multivariable models for QuickDASH and pain intensity included PSEQ and PHQ and explained 35 % and 28 % of the variability respectively. Upper extremity specific disability and pain intensity are limited more by self-efficacy than cognitive flexibility. Interventions to improve self-efficacy might help patients with upper extremity illness.

Keywords

Cognitive flexibility scale - Pain intensity - Disability - Upper extremity - Self-efficacy

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References

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