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Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes

This paper focuses on a novel application of personalized medicine: the ways one thinks about health (i.e., appraisal processes) as relevant predictors of spine-surgery response. This prospective longitudinal cohort study (n = 235) investigated how appraisal processes relate to outcomes of spinal de...

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Autores principales: Schwartz, Carolyn E., Rapkin, Bruce D., Borowiec, Katrina, Finkelstein, Joel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605664/
https://www.ncbi.nlm.nih.gov/pubmed/36294682
http://dx.doi.org/10.3390/jpm12101545
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author Schwartz, Carolyn E.
Rapkin, Bruce D.
Borowiec, Katrina
Finkelstein, Joel A.
author_facet Schwartz, Carolyn E.
Rapkin, Bruce D.
Borowiec, Katrina
Finkelstein, Joel A.
author_sort Schwartz, Carolyn E.
collection PubMed
description This paper focuses on a novel application of personalized medicine: the ways one thinks about health (i.e., appraisal processes) as relevant predictors of spine-surgery response. This prospective longitudinal cohort study (n = 235) investigated how appraisal processes relate to outcomes of spinal decompression and/or fusion surgery, from pre-surgery through one-year post-surgery. Patient-reported outcomes assessed spine-specific disability (Oswestry Disability Index (ODI)), mental health functioning (Rand-36 Mental Component Score (MCS)), and cognitive appraisal processes (how people recall past experiences and to whom they compare themselves). Analysis of Variance examined the appraisal-outcomes association in separate models at pre-surgery, 3 months, and 12 months. We found that appraisal processes explained less variance at pre-surgery than later and were differentially relevant to health outcomes at different times in the spine-surgery recovery trajectory. For the ODI, recall of the seriousness of their condition was most prominent early in recovery, and comparing themselves to positive standards was most prominent later. For the MCS, not focusing on the negative aspects of their condition and/or on how others see them was associated with steady improvement and higher scores at 12 months. Appraisal processes are relevant to both spine-specific disability and mental-health functioning. Such processes are modifiable objects of attention for personalizing spine-surgery outcomes.
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spelling pubmed-96056642022-10-27 Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes Schwartz, Carolyn E. Rapkin, Bruce D. Borowiec, Katrina Finkelstein, Joel A. J Pers Med Article This paper focuses on a novel application of personalized medicine: the ways one thinks about health (i.e., appraisal processes) as relevant predictors of spine-surgery response. This prospective longitudinal cohort study (n = 235) investigated how appraisal processes relate to outcomes of spinal decompression and/or fusion surgery, from pre-surgery through one-year post-surgery. Patient-reported outcomes assessed spine-specific disability (Oswestry Disability Index (ODI)), mental health functioning (Rand-36 Mental Component Score (MCS)), and cognitive appraisal processes (how people recall past experiences and to whom they compare themselves). Analysis of Variance examined the appraisal-outcomes association in separate models at pre-surgery, 3 months, and 12 months. We found that appraisal processes explained less variance at pre-surgery than later and were differentially relevant to health outcomes at different times in the spine-surgery recovery trajectory. For the ODI, recall of the seriousness of their condition was most prominent early in recovery, and comparing themselves to positive standards was most prominent later. For the MCS, not focusing on the negative aspects of their condition and/or on how others see them was associated with steady improvement and higher scores at 12 months. Appraisal processes are relevant to both spine-specific disability and mental-health functioning. Such processes are modifiable objects of attention for personalizing spine-surgery outcomes. MDPI 2022-09-20 /pmc/articles/PMC9605664/ /pubmed/36294682 http://dx.doi.org/10.3390/jpm12101545 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schwartz, Carolyn E.
Rapkin, Bruce D.
Borowiec, Katrina
Finkelstein, Joel A.
Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title_full Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title_fullStr Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title_full_unstemmed Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title_short Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes
title_sort cognitive processes during recovery: moving toward personalized spine surgery outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605664/
https://www.ncbi.nlm.nih.gov/pubmed/36294682
http://dx.doi.org/10.3390/jpm12101545
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