Psychological distress mediates the relationship between pain and disability in hand or wrist fractures

Ross, Cassie; Juraskova, Ilona; Lee, Hopin; Parkitny, Luke; Stanton, Tasha R.; Moseley, G. Lorimer; McAuley, James H.

doi:10.1016/j.jpain.2015.05.007

Cited by 42Orthopedic Surgery and RehabilitationMusculoskeletal pain and rehabilitationBone fractures and treatments

Psychological distress mediates the relationship between pain and disability in hand or wrist fractures

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Ross, Cassie, Juraskova, Ilona, Lee, Hopin, Parkitny, Luke, Stanton, Tasha R., Moseley, G. Lorimer, McAuley, James H.·2015·The Journal of Pain

DOI 10.1016/j.jpain.2015.05.007

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Abstract

Upper limb fracture is a common musculoskeletal injury and can lead to marked pain-related disability. Unlike other common painful musculoskeletal conditions, such as low back pain, little consideration has been given to the role that psychological variables may play in explaining the relationship between pain and disability during early fracture recovery. This cross-sectional study aimed to determine if psychological distress (symptoms of depression, anxiety, and/or stress) mediate the relationship between pain and disability in acute hand/wrist fractures. Self-reported data from a consecutive sample of 594 patients with acute hand/wrist fracture were used. Mediation analyses were conducted to determine the role of depression, anxiety, and stress in the relationship between pain and disability, controlling for relevant demographic and fracture-related variables. Depression and stress, but not anxiety, significantly mediated the relationship between pain and disability. That is, although each psychological distress variable was associated with pain (P < .001), only depression (b1 = 0.27, P = .03) and stress (b3 = .23, P = .02) were significantly associated with disability and fulfilled recommended criteria for establishing a mediating variable. Increased depression and stress, but not anxiety, explain the relationship between pain and disability and may be novel targets for interventions designed to reduce pain-related disability after upper limb fracture. Perspective: This study presents the mediating effect of psychological distress on the relationship between pain and disability in acute upper limb fracture. These factors may be novel targets for interventions designed to reduce pain-related disability after acute fracture.

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Authors: Ross, C., Juraskova, I., Lee, H., Parkitny, L., Stanton, T. R., Moseley, G. L., & McAuley, J. H.
Affiliations: University of California, San Francisco (US)
The University of Sydney (AU)
UNSW Sydney (AU)
University of Alabama at Birmingham (US)
University of South Australia (AU)
Corresponding author: McAuley, James H.
ORCID: Ross, Cassie
Juraskova, Ilona
Lee, Hopin
Parkitny, Luke
Stanton, Tasha R.
Moseley, G. Lorimer
McAuley, James H.
Venue: The Journal of Pain
Publisher: Elsevier BV
Published: 2015-09
Volume: 16
Issue: 9
Pages: 836-843
ISSN: 1526-5900 (ISSN-L)
DOI: 10.1016/j.jpain.2015.05.007
OpenAlex: W2121534797
Cited by: 42
References: 35
Citations by year: 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 7 · 2017: 5 · 2016: 4
FWCI: 5.38
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2932 d)
Locations: Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders: Medical Research Council
National Health and Medical Research Council (1017607, 1054041, 630431)
Topics: Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
Keywords: psychological distress, hand fractures, wrist fractures, upper extremity fractures, pain-related disability, depression, anxiety, stress, mediation, fracture recovery
MeSH terms: Adolescent, Adult, Aged, Cross-Sectional Studies, Depression, Disability Evaluation, Female, Hand Injuries, Disabled Persons, Persons with Disabilities, Humans, Male, Middle Aged, Pain, Statistics as Topic, Stress, Psychological, Wrist Injuries, Models, Statistical, Young Adult

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Psychological distress mediates the relationship between pain and disability in hand or wrist fractures

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