The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Procedure
2.2. Measurement Instruments
- A Numeric Rating Scale (NRS) measuring pain intensity ranging from 0 (“No pain”) to 10 (“Worst possible pain”) [15].
- The Italian Pain Questionnaire (IPQ) [16]. The IPQ assesses the sensory, affective and evaluative components of the patient’s pain experience. It is the Italian version of the McGill Pain Questionnaire, which was translated and modified to overcome the cross-cultural differences of the semantics of pain. The IPQ includes 42 pain descriptors divided into four main classes (sensory, affective, evaluative and mixed), and 16 sub-classes corresponding to those of the McGill Pain Questionnaire. Every sub-class has a variable number (from 2 to 5) of descriptors in ascendant order and every descriptor has a corresponding value in the scoring of the respective component based on its position. The average of the scoring of the descriptors of each component is named Pain Rating Index (PRI). Therefore, four PRI were calculated, namely PRI-Sensory (PRI-S), PRI-Affective (PRI-A), PRI-Evaluative (PRI-E) and PRI-Mixed (PRI-M).
- The Pain Catastrophizing Scale (PCS) [17]. The PCS assesses the frequency of thoughts and feelings associated with pain using 13 items on a 5-point Likert scale (from 0 = “not at all” to 4 = “all the time”). The Italian version of PCS has shown good reliability and construct validity [18]. In this study, its total score was employed [19]. Higher scores in the PCS indicate higher levels of pain catastrophizing.
- The Tampa Scale of Kinesiophobia (TSK) [20,21]. The TSK assesses pain-related fear of movement and re-injury using 17 items on a 4-point Likert scale (from 1 = “completely disagree” to 4 = “completely agree”). The TSK includes two subscales: Harm (TSK-H), which assesses beliefs that there is something wrong with the body, and Avoidance of activities (TSK-A), which assesses beliefs that avoiding exercise or activities might prevent an increase in pain. Higher values indicate a higher fear of movement. The Italian version showed good psychometric properties [20].
- Card A and B of the Cognitive-Behavioral Assessment—Hospital form (CBA-H) [22]. The CBA-H was developed to evaluate the psychological status of patients with physical illnesses, taking into account both state and trait variables. Card A includes 21 items focusing on the psychological status at the moment of administration and includes three subscales, namely State Anxiety (CBA-H-A), Healthcare-related Fears (CBA-H-HF) and Situational Depressive reactions (CBA-H-SD). Card B includes 23 items focusing on the three months preceding the moment of administration and examines Depressive mood (CBA-H-D), Psychophysical Stress (CBA-H-PS) and psychophysical Well-Being (CBA-H-WB). The responses are coded using a dichotomous yes/no response. The scale showed adequate reliability and good structural and construct validity [23].
- The Trail Making Test (TMT) [24]. The TMT is a neuropsychological test which includes two parts. In part A (TMT-A), the patient is required to connect numbered circles drawing consecutive lines. In part B (TMT-B), the patient is required to connect consecutively numbered letters and circles, alternating between letters and numbers. Time to complete the TMT-A is considered a measure of attention and visual scanning. Time to complete the TMT-B is considered a measure of set-shifting and cognitive flexibility. Italian norms were employed to adjust the raw scores taking into account age and education [25].
2.3. Statistical Analyses
3. Results
3.1. Participants Characteristics
3.2. Predictors of Pain Intensity
3.3. Predictors of the Components of Pain
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Laufenberg-Feldmann, R.; Kappis, B.; Mauff, S.; Schmidtmann, I.; Ferner, M. Prevalence of pain 6 months after surgery: A prospective observational study. BMC Anesthesiol. 2016, 16, 91. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fuzier, R.; Rousset, J.; Bataille, B.; Salces-Y-Nédéo, A.; Maguès, J.-P. One half of patients reports persistent pain three months after orthopaedic surgery. Anaesth. Crit. Care Pain Med. 2015, 34, 159–164. [Google Scholar] [CrossRef] [PubMed]
- Weir, S.; Samnaliev, M.; Kuo, T.C.; Ni Choitir, C.; Tierney, T.S.; Cumming, D.; Bruce, J.; Manca, A.; Taylor, R.; Eldabe, S. The incidence and healthcare costs of persistent postoperative pain following lumbar spine surgery in the UK: A cohort study using the clinical practice research datalink (CPRD) and hospital episode statistics (HES). BMJ Open 2017, 7, e017585. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Luzzati, F.; Giusti, E.M.; Scotto, G.M.; Perrucchini, G.; Cannavò, L.; Castelnuovo, G.; Cottini, A.C. Quality of life, pain, and psychological factors in patients undergoing surgery for primary tumors of the spine. Support. Care Cancer 2019, 28, 1385–1393. [Google Scholar] [CrossRef] [PubMed]
- Giusti, E.M.; Lacerenza, M.; Manzoni, G.M.; Castelnuovo, G. Psychological and psychosocial predictors of chronic post-surgical pain. Pain 2020. [Google Scholar] [CrossRef]
- Castelnuovo, G.; Giusti, E.M.; Manzoni, G.M.; Saviola, D.; Gatti, A.; Gabrielli, S.; Lacerenza, M.; Pietrabissa, G.; Cattivelli, R.; Spatola, C.A.M.; et al. Psychological considerations in the assessment and treatment of pain in neurorehabilitation and psychological factors predictive of therapeutic response: Evidence and recommendations from the italian consensus conference on pain in neurorehabilitation. Front. Psychol. 2016, 7. [Google Scholar] [CrossRef]
- Edwards, R.R.; Dworkin, R.H.; Sullivan, M.D.; Turk, D.C.; Wasan, A.D. The role of psychosocial processes in the development and maintenance of chronic pain. J. Pain 2016, 17, T70–T92. [Google Scholar] [CrossRef] [Green Version]
- Diamond, A. Executive functions. Annu. Rev. Psychol. 2013, 64, 135–168. [Google Scholar] [CrossRef] [Green Version]
- Bunk, S.; Preis, L.; Zuidema, S.; Lautenbacher, S.; Kunz, M. Executive functions and pain. Zeitschrift für Neuropsychol. 2019, 30, 169–196. [Google Scholar] [CrossRef]
- Attal, N.; Masselin-Dubois, A.; Martinez, V.; Jayr, C.; Albi, A.; Fermanian, J.; Bouhassira, D.; Baudic, S. Does cognitive functioning predict chronic pain? Results from a prospective surgical cohort. Brain 2014, 137, 904–917. [Google Scholar] [CrossRef] [Green Version]
- Price, D.D. Psychological and neural mechanisms of the affective dimension of pain. Science 2000, 288, 1769–1772. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Auvray, M.; Myin, E.; Spence, C. The sensory-discriminative and affective-motivational aspects of pain. Neurosci. Biobehav. Rev. 2010, 34, 214–223. [Google Scholar] [CrossRef] [PubMed]
- Campos, H.L.M.; Liebano, R.E.; Lima, C.A.; Perracini, M.R. Multidimensional investigation of chronic pain experience and physical functioning following hip fracture surgery: Clinical implications. Br. J. Pain 2020, 14, 5–13. [Google Scholar] [CrossRef] [PubMed]
- Treede, R.D.; Rief, W.; Barke, A.; Aziz, Q.; Bennett, M.I.; Benoliel, R.; Cohen, M.; Evers, S.; Finnerup, N.; First, M.B.; et al. A classification of chronic pain for ICD-11. Pain 2015, 156, 1003–1007. [Google Scholar] [CrossRef] [Green Version]
- Jensen, M.P.; Turner, J.A.; Romano, J.M.; Fisher, L.D. Comparative reliability and validity of chronic pain intensity measures. Pain 1999, 83, 157–162. [Google Scholar] [CrossRef]
- De Benedittis, G.; Massel, R.; Nobili, R.; Pieri, A. The Italian pain questionnaire. Pain 1988, 33, 53–62. [Google Scholar] [CrossRef]
- Sullivan, M.J.L.; Bishop, S.R.; Pivik, J. The pain catastrophizing scale: Development and validation. Psychol. Assess. 1995, 7, 524–532. [Google Scholar] [CrossRef]
- Monticone, M.; Baiardi, P.; Ferrari, S.; Foti, C.; Mugnai, R.; Pillastrini, P.; Rocca, B.; Vanti, C. Development of the Italian version of the Pain Catastrophising Scale (PCS-I): Cross-cultural adaptation, factor analysis, reliability, validity and sensitivity to change. Qual. Life Res. 2011, 21, 1045–1050. [Google Scholar] [CrossRef]
- Meroni, R.; Piscitelli, D.; Bonetti, F.; Zambaldi, M.; Cerri, C.G.; Guccione, A.A.; Pillastrini, P. Rasch analysis of the Italian version of pain catastrophizing scale (PCS-I). J. Back Musculoskelet. Rehabilit. 2014, 28, 661–673. [Google Scholar] [CrossRef]
- Monticone, M.; Giorgi, I.; Baiardi, P.; Barbieri, M.; Rocca, B.; Bonezzi, C. Development of the Italian version of the tampa scale of Kinesiophobia (TSK-I): Cross-cultural adaptation, factor analysis, reliability, and validity. Spine 2010, 35, 1241–1246. [Google Scholar] [CrossRef]
- Kori, S.; Miller, R.; Todd, D. Kinesophobia: A new view of chronic pain behaviour. Pain Manag. 1990, 3, 35–43. [Google Scholar]
- Zotti, A.M.; Bettinardi, O.; Michielin, P.; Sanavio, E.; Vidotto, G. Forma H della batteria CBA-2.0: Edizione Speciale GISSI2. Boll. Psicol. Appl. 1989, 191–192, 57–62. [Google Scholar]
- Zotti, A.M.; Bertolotti, G.; Michielin, P.; Sanavio, E.; Vidotto, G. CBA Forma H (Hospital): Manuale; Giunti-OS.: Firenze, Italy, 2010. [Google Scholar]
- Reitan, R.M. Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Mot. Skills 1958, 8, 271–276. [Google Scholar] [CrossRef]
- Giovagnoli, A.R.; Del Pesce, M.; Mascheroni, S.; Simoncelli, M.; Laiacona, M.; Capitani, E. Trail making test: Normative values from 287 normal adult controls. Neurol. Sci. 1996, 17, 305–309. [Google Scholar] [CrossRef]
- Van Ginkel, J.R.; Linting, M.; Rippe, R.C.A.; Van Der Voort, A. Rebutting existing misconceptions about multiple imputation as a method for handling missing Data. J. Pers. Assess. 2020, 102, 297–308. [Google Scholar] [CrossRef] [Green Version]
- Azur, M.; Stuart, E.A.; Frangakis, C.; Leaf, P.J. Multiple imputation by chained equations: What is it and how does it work? Int. J. Methods Psychiatr. Res. 2011, 20, 40–49. [Google Scholar] [CrossRef]
- Pinheiro, J.S.; Bates, D.; DebRoy, S.; Sarkar, D.; R Core Team. {Nlme}: Linear and Nonlinear Mixed Effects Models. 2018. Available online: https://CRAN.R-project.org/package=nlme (accessed on 27 September 2020).
- Katz, J.; Burns, L.C.; Ritvo, S.E.; Ferguson, M.K.; Clarke, H.; Seltzer, Z. Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: A systematic review. J. Pain Res. 2015, 8, 21–32. [Google Scholar] [CrossRef] [Green Version]
- Katz, J.; Seltzer, Z. Transition from acute to chronic postsurgical pain: Risk factors and protective factors. Expert Rev. Neurother. 2009, 9, 723–744. [Google Scholar] [CrossRef] [Green Version]
- Kim, D.H.; Pearson-Chauhan, K.M.; McCarthy, R.J.; Buvanendran, A.; Pharm, D. Predictive factors for developing chronic pain after total knee arthroplasty. J. Arthroplast. 2018, 33, 3372–3378. [Google Scholar] [CrossRef]
- Liu, Y.; Zhou, M.; Zhu, X.; Gu, X.; Ma, Z.; Zhang, W. Risk and protective factors for chronic pain following inguinal hernia repair: A retrospective study. J. Anesth. 2020, 34, 330–337. [Google Scholar] [CrossRef]
- Buvanendran, A.; Della Valle, C.J.; Kroin, J.S.; Shah, M.; Moric, M.; Tuman, K.J.; McCarthy, R.J. Acute postoperative pain is an independent predictor of chronic postsurgical pain following total knee arthroplasty at 6 months: A prospective cohort study. Reg. Anesth. Pain Med. 2019, 44, 287–296. [Google Scholar] [CrossRef]
- Nes, L.S.; Roach, A.R.; Segerstrom, S.C. Executive functions, self-regulation, and chronic pain: A review. Ann. Behav. Med. 2009, 37, 173–183. [Google Scholar] [CrossRef]
- Lautenbacher, S.; Huber, C.; Schöfer, D.; Kunz, M.; Parthum, A.; Weber, P.G.; Roman, C.; Griessinger, N.; Sittl, R. Attentional and emotional mechanisms related to pain as predictors of chronic postoperative pain: A comparison with other psychological and physiological predictors. Pain 2010, 151, 722–731. [Google Scholar] [CrossRef]
- Castelnuovo, G.; Giusti, E.M.; Manzoni, G.M.; Saviola, D.; Gatti, A.; Gabrielli, S.; Lacerenza, M.; Pietrabissa, G.; Cattivelli, R.; Spatola, C.A.M.; et al. Psychological treatments and psychotherapies in the neurorehabilitation of pain: Evidences and recommendations from the Italian consensus conference on pain in neurorehabilitation. Front. Psychol. 2016, 7. [Google Scholar] [CrossRef]
- Giusti, E.M.; Pietrabissa, G.; Manzoni, G.M.; Cattivelli, R.; Molinari, E.; Trompetter, H.R.; Schreurs, K.M.G.; Castelnuovo, G. The economic utility of clinical psychology in the multidisciplinary management of pain. Front. Psychol. 2017, 8, 1860. [Google Scholar] [CrossRef]
- Wang, L.; Chang, Y.; Kennedy, S.; Hong, P.; Chow, N.; Couban, R.; McCabe, R.; Bieling, P.; Busse, D.J.W. Perioperative psychotherapy for persistent post-surgical pain and physical impairment: A meta-analysis of randomised trials. Br. J. Anaesth. 2018, 120, 1304–1314. [Google Scholar] [CrossRef] [Green Version]
Surgical Area | |||||||
---|---|---|---|---|---|---|---|
Knee (n = 76) | Total (n = 167) | Foot (n = 60) | Shoulder (n = 20) | Hip (n = 11) | p * | ||
Sex | Male | 47 (28.1) | 26 (34.2) | 6 (10) | 11 (55) | 4 (36.4) | |
Female | 120 (71.9) | 50 (65.8) | 54 (90) | 9 (45) | 7 (63.6) | <0.01 | |
Age | 55 (15.5) | 54.2 (18.2) | 53.8 (12.6) | 55.6 (13.6) | 66.3 (8.7) | 0.09 | |
Occupation | Unemployed | 26 (15.6) | 12 (15.8) | 10 (16.7) | 1 (5.0) | 3 (27.3) | |
Worker | 90 (53.9) | 41 (53.9) | 35 (58.3) | 12 (60.0) | 2 (18.2) | ||
Retired | 51 (30.5) | 23 (30.3) | 15 (25.0) | 7 (35.0) | 6 (54.5) | 0.22 | |
Civil status | Single | 32 (19.2) | 20 (26.3) | 8 (13.3) | 4 (20.0) | 0 (0.0) | |
Coupled or married | 106 (63.5) | 40 (52.6) | 44 (73.3) | 15 (75.0) | 7 (63.6) | ||
Divorced | 6 (3.6) | 3 (3.9) | 2 (3.3) | 1 (5.0) | 0 (0.0) | ||
Widow | 23 (13.8) | 13 (17.1) | 6 (10.0) | 0 (0.0) | 4 (36.4) | 0.06 | |
Education | Elementary or middle school | 53 (31.7) | 24 (31.6) | 12 (20.0) | 10 (50.0) | 7 (63.6) | |
High school | 80 (47.9) | 38 (50.0) | 31 (51.7) | 7 (35.0) | 4 (36.4) | ||
University | 34 (20.4) | 14 (18.4) | 17 (28.3) | 3 (15.0) | 0 (0.0) | 0.03 | |
Pain duration | Less than one month | 12 (7.2) | 9 (11.8) | 3 (5.0) | 0 (0.0) | 0 (0.0) | |
Less than one year | 57 (34.1) | 33 (43.4) | 9 (15.0) | 12 (60.0) | 3 (27.3) | ||
More than one year | 98 (58.7) | 34 (44.7) | 48 (80.0) | 8 (40.0) | 8 (72.7) | <0.01 | |
CBA-H-A | 2.5 (2.7) | 2.7 (2.8) | 2.1 (2.5) | 2 (2.4) | 3.9 (3.3) | 0.14 | |
CBA-H-HF | 1.3 (1.2) | 1.4 (1.3) | 1.3 (1.2) | 1.1 (1.2) | 1.5 (1.1) | 0.8 | |
CBA-H-SD | 0.5 (0.9) | 0.6 (0.9) | 0.4 (0.8) | 0.6 (1) | 0.7 (0.8) | 0.64 | |
CBA-H-D | 3.2 (2.7) | 3.5 (2.8) | 2.4 (2.4) | 2.8 (2.4) | 5.5 (3) | <0.01 | |
CBA-H-WB | 3.5 (1.9) | 3.4 (1.9) | 3.9 (1.8) | 3.1 (2) | 2.4 (1.9) | 0.07 | |
CBA-H-PS | 2.7 (2) | 2.7 (1.9) | 2.5 (2.2) | 2 (2) | 3.8 (2.2) | 0.13 | |
PCS | 16 (10) | 15.9 (9.9) | 16.9 (10.2) | 17.6 (10.1) | 21.7 (8.8) | 0.31 | |
TSK-H | 2.3 (0.7) | 2.4 (0.5) | 2 (0.7) | 2.4 (0.8) | 2.7 (0.6) | <0.01 | |
TSK-A | 2.2 (0.8) | 2.4 (0.8) | 1.8 (0.7) | 2.5 (0.7) | 3 (0.7) | <0.01 | |
TMT-A | 39 (23.2) | 39.7 (24) | 35.7 (17) | 34.6 (18.1) | 59.6 (41.6) | 0.01 | |
TMT-B | 90.7 (44.4) | 94 (49.1) | 88.9 (32.1) | 83 (39) | 91.5 (73.7) | 0.78 | |
NRS | 6 (2.4) | 5.6 (2.5) | 6.2 (2.4) | 6 (2.5) | 6.8 (1.8) | 0.31 | |
PRI-S | 0.2 [0.1, 0.3] | 0.2 [0.1, 0.3] | 0.2 [0.1, 0.3] | 0.2 [0.1, 0.3] | 0.3 [0.2, 0.3] | 0.51 | |
PRI-A | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.2] | 0.1 [0.0, 0.2] | 0.1 [0.0, 0.3] | 0.3 [0.3, 0.4] | 0.01 | |
PRI-E | 0.1 [0.0, 0.3] | 0.1 [0.1, 0.2] | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.3] | 0.3 [0.1, 0.4] | 0.23 | |
PRI-M | 0.1 [0.0, 0.2] | 0.1 [0.0, 0.2] | 0.1 [0.0, 0.2] | 0.2 [0.0, 0.3] | 0.2 [0.0, 0.3] | 0.37 | |
Variables assessed after surgery (n = 142) | |||||||
NRS | 4.7 (3.1) | 4.8 (2.9) | 4.7 (3.3) | 4.7 (3) | 3.7 (3.1) | 0.79 | |
PRI-S | 0.2 [0.1, 0.4] | 0.2 [0.1, 0.3] | 0.2 [0.1, 0.4] | 0.2 [0.1, 0.4] | 0.1 [0.1, 0.2] | 0.67 | |
PRI-A | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.2] | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.3] | 0.97 | |
PRI-E | 0.1 [0.0, 0.3] | 0.1 [0.1, 0.3] | 0.1 [0.0, 0.3] | 0.1 [0.0, 0.2] | 0 [0.0, 0.1] | 0.51 | |
PRI-M | 0 [0.0, 0.2] | 0 [0.0, 0.2] | 0 [0.0, 0.2] | 0 [0.0, 0.2] | 0 [0.0, 0.2] | 0.70 | |
Variables assessed at follow-up (n = 104) | |||||||
NRS | 2.5 (2.7) | 2.7 (2.8) | 1.7 (2.6) | 3.5 (2.5) | 2.2 (1.5) | 0.21 | |
PRI-S | 0.1 [0.0, 0.2] | 0.1 [0.1, 0.2] | 0 [0.0, 0.1] | 0.1 [0.1, 0.2] | 0.1 [0.1, 0.1] | 0.02 | |
PRI-A | 0 [0.0, 0.1] | 0 [0.0, 0.2] | 0 [0, 0] | 0 [0.0, 0.2] | 0 [0, 0] | 0.44 | |
PRI-E | 0.1 [0.0, 0.7] | 0.2 [0.0, 2.3] | 0 [0.0, 0.2] | 0.4 [0.1, 1.0] | 1.2 [0.7, 2.2] | 0.01 | |
PRI-M | 0 [0.0, 0.9] | 0 [0.0, 1.2] | 0 [0.0, 0.1] | 0 [0.0, 1.2] | 0.9 [0.0, 1.1] | 0.25 |
B | Se | p | |
---|---|---|---|
Sex | 0.056 | 0.129 | 0.67 |
Age | −0.003 | 0.004 | 0.49 |
Area—Feet a | 0.139 | 0.119 | 0.24 |
Area—Shoulder a | −0.124 | 0.167 | 0.46 |
Area—Hip a | −0.624 | 0.209 | <0.01 * |
Pain duration—less than one year b | 0.225 | 0.277 | 0.42 |
Pain duration—more than one year b | 0.231 | 0.271 | 0.40 |
CBA-H-A | −0.108 | 0.086 | 0.21 |
CBA-H-HF | 0.020 | 0.081 | 0.80 |
CBA-H-SD | −0.070 | 0.059 | 0.24 |
CBA-H-D | 0.080 | 0.083 | 0.33 |
CBA-H-WB | 0.002 | 0.062 | 0.97 |
CBA-H-PS | −0.022 | 0.065 | 0.74 |
PCS | 0.401 | 0.070 | 0.00 * |
TSK-H | −0.007 | 0.060 | 0.91 |
TSK-A | 0.102 | 0.069 | 0.14 |
TMT-A | 0.169 | 0.074 | 0.03 * |
TMT-B | −0.050 | 0.070 | 0.47 |
PRI-S | PRI-A | PRI-E | PRI-M | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
B | se | p | B | se | p | B | se | p | B | se | p | |
Sex | 0.019 | 0.094 | 0.84 | 0.021 | 0.101 | 0.83 | 0.002 | 0.095 | 0.98 | −0.056 | 0.103 | 0.59 |
Age | −0.002 | 0.003 | 0.37 | 0.000 | 0.003 | 0.94 | −0.003 | 0.003 | 0.36 | 0.000 | 0.003 | 0.88 |
Area—Feet a | −0.203 | 0.095 | 0.03 * | −0.009 | 0.100 | 0.93 | −0.015 | 0.094 | 0.87 | 0.047 | 0.107 | 0.66 |
Area—Shoulder a | −0.745 | 0.122 | <0.01* | −0.588 | .126 | <0.01 * | −0.635 | 0.123 | <0.01 * | −0.392 | 0.133 | <0.01 * |
Area—Hip a | −0.799 | 0.155 | <0.01 * | −0.347 | 0.157 | 0.03* | −0.547 | 0.165 | <0.01* | −0.681 | 0.186 | <0.01 * |
Pain duration—less than one year b | 0.077 | 0.200 | 0.70 | −0.283 | 0.222 | 0.21 | −0.198 | 0.160 | 0.22 | −0.311 | 0.228 | 0.18 |
Pain duration—more than one year b | −0.047 | 0.201 | 0.82 | −0.378 | 0.217 | 0.09 | −0.285 | 0.165 | 0.09 | −0.441 | 0.249 | 0.08 |
CBA-H-A | −0.233 | 0.068 | <.001 * | −0.253 | 0.065 | <0.01* | −0.273 | 0.062 | <0.01 * | −0.373 | 0.070 | <0.01 * |
CBA-H-HF | −0.195 | 0.066 | <0.01 * | −0.118 | 0.066 | 0.08 | −0.100 | 0.062 | 0.11 | −0.151 | 0.071 | 0.04 * |
CBA-H-SD | −0.006 | 0.043 | 0.90 | -0.059 | 0.048 | 0.22 | 0.006 | 0.043 | 0.89 | 0.010 | 0.052 | 0.85 |
CBA-H-D | −0.106 | 0.061 | 0.09 | 0.018 | 0.062 | 0.77 | 0.050 | 0.059 | 0.40 | 0.035 | 0.066 | 0.59 |
CBA-H-WB | 0.052 | 0.050 | 0.30 | −0.088 | 0.052 | 0.09 | −0.011 | 0.049 | 0.83 | 0.015 | 0.059 | 0.80 |
CBA-H-PS | 0.096 | 0.053 | 0.07 | −0.022 | 0.056 | 0.70 | 0.020 | 0.053 | 0.70 | 0.137 | 0.063 | 0.03 * |
PCS | 1.058 | 0.060 | <0.01 * | 0.911 | 0.057 | <0.01* | 0.874 | 0.054 | <0.01 * | 0.888 | 0.059 | <0.01 * |
TSK-H | 0.025 | 0.048 | 0.60 | 0.083 | 0.047 | 0.08 | 0.065 | 0.046 | 0.16 | −0.017 | 0.050 | 0.73 |
TSK-A | −0.007 | 0.049 | 0.89 | −0.033 | 0.052 | 0.53 | 0.002 | 0.048 | 0.97 | 0.062 | 0.054 | 0.26 |
TMT-A | −0.192 | 0.055 | <0.01 * | −0.076 | 0.056 | 0.18 | −0.037 | 0.053 | 0.49 | 0.028 | 0.060 | 0.65 |
TMT-B | 0.051 | 0.050 | 0.31 | 0.021 | 0.053 | 0.69 | 0.024 | 0.049 | 0.62 | −0.062 | 0.053 | 0.24 |
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Giusti, E.M.; Manna, C.; Varallo, G.; Cattivelli, R.; Manzoni, G.M.; Gabrielli, S.; D’Amario, F.; Lacerenza, M.; Castelnuovo, G. The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study. Brain Sci. 2020, 10, 685. https://doi.org/10.3390/brainsci10100685
Giusti EM, Manna C, Varallo G, Cattivelli R, Manzoni GM, Gabrielli S, D’Amario F, Lacerenza M, Castelnuovo G. The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study. Brain Sciences. 2020; 10(10):685. https://doi.org/10.3390/brainsci10100685
Chicago/Turabian StyleGiusti, Emanuele Maria, Chiara Manna, Giorgia Varallo, Roberto Cattivelli, Gian Mauro Manzoni, Samantha Gabrielli, Federico D’Amario, Marco Lacerenza, and Gianluca Castelnuovo. 2020. "The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study" Brain Sciences 10, no. 10: 685. https://doi.org/10.3390/brainsci10100685