100 | wetenschapsdag 2023 Sessie 3c: Zing, Vecht, Huil, Bid, Lach, Werk en Bewonder 4 Auteurs D.E. de Gruijter, L.S. Blaas, R.E. Boeschoten, P. van Oppen, R.J. Derksen Abstract titel Assessing the potential improvement on PROMs of cognitive behavioural therapy in mentally vulnerable patients with a surgically treated proximal humerus fracture; A study protocol for a randomized controlled trial. ELEVATE study; does lifting spirits help lift the arm? Background Shoulder injuries are among the most common injuries presented in the Emergency Department. (1,2) Although physical factors play an important role in the treatment and outcomes after a proximal humerus fracture, psychological factors need to be taking into account as well. Few studies have been done to the influence of psychosocial factors on the outcomes after shoulder surgery and show that it is negatively correlated. (3-5, 6) Personality traits influence outcomes of health and disease. Neuroticism is the trait shown to be most important concerning worse outcomes. (7,8) Cognitive behavioural therapy (CGT) is provided to people having neuroticism to help cope with unhelpful beliefs and behaviours. CGT has also shown to positively affect satisfactions in patients undergoing TKA. (9,10) Although studies have been done to objectify the correlation between psychological factors and patient related outcomes measurements (PROMs) after surgery, there has not yet been a trial where an intervention has taken place to better the PROMs when patients have neurotic tendencies. Methods This study is a, multi-centre, non-blinded, randomized controlled trial. The aim of this study is to assess the benefit of concomitant psychological guidance in patients with proximal humerus fractures and neuroticism on the PROMs. All patients (18+) undergoing surgical repair of a proximal humerus fracture and having neuroticism will be randomized to receive standard care or standard care and psychological guidance, consisting of CGT and relaxational exercises. Baseline data collection will be conducted at the time of admission. All patients will return to the shoulder expertise centre at 3, 6 and 12 months, where questionnaires will be filled out and outcome indicators will be measured. Results - Conclusion If psychological guidance is effective in improving the outcomes, our findings will promote a new standard of care that incorporates psychological guidance as part of the recovery after proximal humerus fracture.
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