Objective

To investigate how satisfaction with treatment outcome is associated with patient mindset and Michigan Hand Outcome Questionnaire (MHQ) scores at baseline and 3 months in patients receiving nonoperative treatment for first carpometacarpal joint (CMC-1) osteoarthritis (OA).

Design

Cohort study

Setting

A total of 20 outpatient locations of a clinic for hand surgery and hand therapy in the Netherlands.

Participants

Patients (N=308) receiving nonoperative treatment for CMC-1 OA, including exercise therapy, an orthosis, or both, between September 2017 and February 2019.

Interventions

Nonoperative treatment (ie, exercise therapy, an orthosis, or both)

Main Outcome Measures

Satisfaction with treatment outcomes was measured after 3 months of treatment. We measured total MHQ score at baseline and at 3 months. As baseline mindset factors, patients completed questionnaires on treatment outcome expectations, illness perceptions, pain catastrophizing, and psychological distress. We used multivariable logistic regression analysis and mediation analysis to identify factors associated with satisfaction with treatment outcomes.

Results

More positive pretreatment outcome expectations were associated with a higher probability of being satisfied with treatment outcomes at 3 months (odds ratio, 1.15; 95% confidence interval, 1.07-1.25). Only a relatively small part (33%) of this association was because of a higher total MHQ score at 3 months. None of the other mindset and hand function variables at baseline were associated with satisfaction with treatment outcomes.

Conclusions

This study demonstrates that patients with higher pretreatment outcome expectations are more likely to be satisfied with treatment outcomes after 3 months of nonoperative treatment for CMC-1 OA. This association could only partially be explained by a better functional outcome at 3 months for patients who were satisfied. Health care providers treating patients nonoperatively for CMC-1 OA should be aware of the importance of expectations and may take this into account in pretreatment counseling.

中文翻译：

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对拇指根部骨关节炎的非手术治疗结果具有更高治疗结果预期的患者更满意：一项队列研究

客观的

研究在接受第一次腕掌关节 (CMC-1) 骨关节炎 (OA) 非手术治疗的患者中，治疗结果的满意度如何与患者心态和密歇根手部结果问卷 (MHQ) 评分在基线和 3 个月时相关。

设计

队列研究

环境

荷兰手外科和手部治疗诊所共有 20 个门诊点。

参与者

2017 年 9 月至 2019 年 2 月期间接受 CMC-1 OA 非手术治疗的患者（N=308），包括运动疗法、矫形器或两者。

干预

非手术治疗（即运动疗法、矫形器或两者兼有）

主要观察指标

在治疗 3 个月后测量对治疗结果的满意度。我们在基线和 3 个月时测量了总 MHQ 评分。作为基线心态因素，患者完成了关于治疗结果预期、疾病感知、疼痛灾难和心理困扰的问卷。我们使用多变量逻辑回归分析和中介分析来确定与治疗结果满意度相关的因素。

结果

更积极的治疗前结果预期与更高的概率在 3 个月时对治疗结果感到满意（优势比，1.15；95% 置信区间，1.07-1.25）。这种关联中只有相对较小的一部分 (33%) 是因为 3 个月时 MHQ 总分较高。基线时的其他心态和手部功能变量均与治疗结果的满意度无关。

结论

该研究表明，对 CMC-1 OA 进行 3 个月的非手术治疗后，治疗前结果预期较高的患者更有可能对治疗结果感到满意。对于满意的患者，这种关联只能部分解释为 3 个月时更好的功能结果。对 CMC-1 OA 患者进行非手术治疗的医疗保健提供者应该意识到期望的重要性，并可能在治疗前咨询中考虑到这一点。