Table 1 Summary of reviewed studies
From: A systematic review of psychological interventions in total hip and knee arthroplasty
Author (Year) | Participants | Type of surgery | Control group | Psychological intervention (Type) | Frequency of sessions + (Mode of delivery) | Pre or Post surgery | Data collection points | Outcome measures (Note: Patient reported joint outcomes in bold) | Main findings about patient reported joint outcomes |
|---|---|---|---|---|---|---|---|---|---|
Berge, Dolin, Williams & Harman (2004) [32] | Total N = 44 Mean age = 71.6 (PMP), 71.0 (controls) Age range = NS | THA | N = 21 TAU | Pain Management Training: education, cognitive behaviour therapy, relaxation (CBT + RT) | Total = 21.5 h; Occurred over 6 weeks; 1 to 2 mornings a week (In-person) | Pre; at least 6 months before surgery | Total = 3; Pre intervention, 3 and 12 months after PMP | Pain (numerical rating scales), Analgesic drug use, function (Arthritis Impact Measurement Scale), metres walked in 4 min | Treatment group had sig. Better function than controls at 12 month follow up. No sig. Difference in pain was found between groups at 12 month follow up. |
Doering et al. (2000) [33] | Total N = 100 Mean age = 58.7 (treatment), 60.4 (control) Age range = NS | THA | N = 54 TAU | Educational video + discussion (PE) | Total = 1 × 12 min video watched with psychologist/psychiatrist (Video recording) | Pre: afternoon of the pre-operative day | Total = 8; 5 consecutive days starting on pre-operation day, 3 months post-surgery | Anxiety (STAI), Depression (Von Zerssen Depression Scale), Pain (VAS), Blood pressure, Heart rate, Stress hormones (Urine samples), intake of analgesics and sedatives | No sig. Difference in pain was found between groups at all time points. |
Forward et al. (2015) [38] | Total N = 224 TKA = 154 THA = 70 Mean age = NS Age range = NS | THA + TKA | N = 75 TAU TKA = NS THA = NS | Guided Imagery: Guided Meditation for Procedures or Surgery (GI) | Total = 4 × 18-20 min sessions: pre-surgery day, post-surgery day 0, 1 and 2 (Audio recording) | Pre and Post: began after admission | Total = 8; pre and post intervention on pre-surgery day, post-surgery day 0, 1 and 2 | Pain (Numeric Rating Scale), Anxiety (Numeric Visual Anxiety Scale, Hamilton Anxiety Scale) | No sig. Differences in pain between GI and controls during overall hospital stay. |
Frost (2003) [34] | Total N = 24 Mean age = 66.2 (treatment), 65.9 (control) Age range = 57–75 | THA | N = 11 Telephone contact only | Motivational Interviewing (MI) | Total = 3 sessions; 1 × 1 h in person, 2 x bi-monthly 15-30 min telephone session (In-person and over the telephone) | Post: began 3 months post-surgery | Total = 2; Pre intervention, 5 months post-surgery | Exercise (diary), Physical activity (Modifiable Activity Questionnaire), Mobility (Gait Speed), Muscle force/balance (Timed Chair Rise), Pain/Stiffness/physical function (WOMAC), physical health and mental health (SF-36), Self-efficacy (Self Efficacy for Exercise Questionnaire), Depression (CESD-10) | No sig. Differences found between groups for all measures at 5 months post-surgery. |
Grossman (2016) [37] | Total N = 60 TKA = 44 THA = 16 Mean age = 66.1 Age range = NS | THA + TKA | N = 15 Education only TKA = 10 THA = 5 | Guided Imagery (GI) | Total = not standardised: 6 min recording pre-surgery twice a day for 1–2 weeks (At least once on day of surgery), encouraged to listen to recording post-surgery but no specific instruction. (Audio recording) | Pre: before admission and before surgery | Total = 3; pre intervention, post intervention (during hospital admission), post-surgery (before discharge) | Anxiety (STAI-S), Stress (Perceived Stress Scale), Coping Strategies (CSQ), Pain (VAS), compliance (Training survey), medication use, length of hospital admission | No sig. Differences between groups for pain overall. |
Jacobson et al. (2016) [36] | Total N = 82 Mean age = 65.0 Age range = 41–81 | TKA | N = 40 Placebo audio recordings | Guided Imagery (GI) | Total = 35 self-directed sessions; Every day for 2 weeks before, and 3 weeks after surgery; 19-21 min each session for treatment, 17-21 min each session for control (Audio recording) | Pre and post: began 2 weeks pre- surgery | Total = 4; 2-3 weeks before surgery (pre-intervention), day of surgery, 3 weeks after surgery (post-intervention), 6 months after surgery | Gait velocity (Timed 10-Meter Walk), functional status (SF-36), Pain/stiffness/function (WOMAC), imaging ability (Imaging Ability Questionnaire), optimism/pessimism (TKR Outcome Expectancy), daily pain (VAS), self-efficacy (Self-Efficacy for Rehabilitation Scale), pain catastrophizing (PCS), fear of movement (Tampa Kinesophobia Scale), CD use questionnaire, Physiological variables (Lymphocytes, macrophages and cytokines) | Treatment group had sig. Reduced pain levels compared to baseline 3 weeks after surgery than control group. No sig. Differences between groups in improvements of knee function at 6 months post-surgery. |
McGregor et al. (2004) [35] | Total N = 39 Mean age = 71.9 Age range = 51–92 | THA | N = 20 TAU | Education + discussion (PE) | Total = 1 x advise class (In-person) | Pre surgery: 2-4 weeks before surgery | Total = 4; Pre-intervention, at admission, at discharge, 3 months post-surgery | Function (WOMAC, Harris Hip Score, Berthel Activities of Daily Living Index), Pain (VAS), Mood states (Positive Affect Negative Affect Scale), helplessness (subscale of Rheumatology Attitudes Index), Fatigue (VAS), expectations of pain/function/satisfaction (VAS), Life satisfaction (Cantril Life Satisfaction Ladder) | No sig. Difference was found between groups for pain and function 3 months post-surgery. No results were reported for differences between groups in fatigue. |