Abstract：
BACKGROUND: Baseline mindset factors are important factors that influence treatment decisions and outcomes. Theoretically, improving the mindset prior to treatment may improve treatment decisions and outcomes. This prospective cohort study evaluated changes in patients\' mindset following hand surgeon consultation. Additionally, we assessed if the change in illness perception differed between surgical and nonsurgical patients.
METHODS: The primary outcome was illness perception, measured using the total score of the Brief Illness Perception Questionnaire (B-IPQ, range 0-80). Secondary outcomes were the B-IPQ subscales, pain catastrophizing (measured using the Pain Catastrophizing Scale (PCS)), and psychological distress (measured using the Patient Health Questionnaire-4).
RESULTS: A total of 276 patients with various hand and wrist conditions completed the mindset questionnaires before and after hand surgeon consultation (median time interval: 15 days). The B-IPQ total score improved from 39.7 (±10.6) before to 35.8 (±11.3) after consultation (p < 0.0001, Cohen\'s d = 0.36); scores also improved for the B-IPQ subscales Coherence, Concern, Emotional Response, Timeline, Treatment Control, and Identity and the PCS. There were no changes in the other outcomes. Surgical patients improved on the B-IPQ subscales Treatment Control and Timeline, while nonsurgical patients did not.
CONCLUSIONS: Illness perception and pain catastrophizing improved following hand surgeon consultation, suggesting that clinicians may actively influence the patients\' mindset during consultations, and that they may try to enhance this effect to improve outcomes. Furthermore, surgical patients improved more in illness perceptions, indicating that nonsurgical patients may benefit from a more targeted strategy for changing mindset.
METHODS: The primary outcome was illness perception, measured using the total score of the Brief Illness Perception Questionnaire (B-IPQ, range 0-80). Secondary outcomes were the B-IPQ subscales, pain catastrophizing (measured using the Pain Catastrophizing Scale (PCS)), and psychological distress (measured using the Patient Health Questionnaire-4).
RESULTS: A total of 276 patients with various hand and wrist conditions completed the mindset questionnaires before and after hand surgeon consultation (median time interval: 15 days). The B-IPQ total score improved from 39.7 (±10.6) before to 35.8 (±11.3) after consultation (p < 0.0001, Cohen\'s d = 0.36); scores also improved for the B-IPQ subscales Coherence, Concern, Emotional Response, Timeline, Treatment Control, and Identity and the PCS. There were no changes in the other outcomes. Surgical patients improved on the B-IPQ subscales Treatment Control and Timeline, while nonsurgical patients did not.
CONCLUSIONS: Illness perception and pain catastrophizing improved following hand surgeon consultation, suggesting that clinicians may actively influence the patients\' mindset during consultations, and that they may try to enhance this effect to improve outcomes. Furthermore, surgical patients improved more in illness perceptions, indicating that nonsurgical patients may benefit from a more targeted strategy for changing mindset.
摘要：
背景：基线心态因素是影响治疗决策和结果的重要因素。理论上,改善治疗前的心态可能会改善治疗决策和结果.这项前瞻性队列研究评估了在手外科医生咨询后患者心态的变化。此外,我们评估了手术和非手术患者的疾病感知变化是否不同.
方法：主要结果是疾病感知，使用简要疾病感知问卷的总分(B-IPQ，范围0-80)。次要结果是B-IPQ分量表，疼痛灾难化（使用疼痛灾难化量表（PCS）测量），和心理困扰（使用患者健康问卷-4进行测量）。
结果：共有276名患有各种手和腕部疾病的患者在手外科医生咨询前后完成了心态问卷（中位时间间隔：15天）。B-IPQ总分从咨询前的39.7（±10.6）提高到咨询后的35.8（±11.3）（p<0.0001，Cohen'sd=0.36）；B-IPQ分量表的连贯性也提高了，关注,情绪反应,时间线,治疗控制,身份和PCS。其他结果没有变化。手术患者在B-IPQ子量表治疗控制和时间表上有所改善，而非手术患者没有。
结论：在手外科医生咨询后，疾病感知和疼痛灾难改善，这表明临床医生可能会在咨询过程中积极影响患者的心态，他们可能会尝试增强这种效果以改善结果。此外，手术患者对疾病的看法有所改善，这表明非手术患者可能受益于更有针对性的改变思维方式的策略。
方法：主要结果是疾病感知，使用简要疾病感知问卷的总分(B-IPQ，范围0-80)。次要结果是B-IPQ分量表，疼痛灾难化（使用疼痛灾难化量表（PCS）测量），和心理困扰（使用患者健康问卷-4进行测量）。
结果：共有276名患有各种手和腕部疾病的患者在手外科医生咨询前后完成了心态问卷（中位时间间隔：15天）。B-IPQ总分从咨询前的39.7（±10.6）提高到咨询后的35.8（±11.3）（p<0.0001，Cohen'sd=0.36）；B-IPQ分量表的连贯性也提高了，关注,情绪反应,时间线,治疗控制,身份和PCS。其他结果没有变化。手术患者在B-IPQ子量表治疗控制和时间表上有所改善，而非手术患者没有。
结论：在手外科医生咨询后，疾病感知和疼痛灾难改善，这表明临床医生可能会在咨询过程中积极影响患者的心态，他们可能会尝试增强这种效果以改善结果。此外，手术患者对疾病的看法有所改善，这表明非手术患者可能受益于更有针对性的改变思维方式的策略。
