Development and validation of an instrument to predict functional recovery in tibial fracture patients: the Somatic Pre-Occupation and Coping (SPOC) questionnaire
Jason W Busse, Mohit Bhandari, Gordon H Guyatt, Diane Heels-Ansdell, Abhaya V Kulkarni, Scott Mandel, David Sanders, Emil Schemitsch, Mark Swiontkowski, Paul Tornetta 3rd, Eugene Wai, Stephen D Walter, SPRINT Investigators & the Medically Unexplained Syndromes Study Group, Mohit Bhandari, Gordon Guyatt, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta, Stephen Walter, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta 3rd, Stephen Walter, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta 3rd, Stephen Walter, Sheila Sprague, Diane Heels-Ansdell, Lisa Buckingham, Pamela Leece, Helena Viveiros, Tashay Mignott, Natalie Ansell, Natalie Sidorkewicz, Julie Agel, Claire Bombardier, Jesse A Berlin, Michael Bosse, Bruce Browner, Brenda Gillespie, Alan Jones, Peter O'Brien, Julie Agel, Sheila Sprague, Rudolf Poolman, Mohit Bhandari, David W Sanders, Mark D Macleod, Timothy Carey, Kellie Leitch, Stuart Bailey, Kevin Gurr, Charlene Bartha, Isolina Low, Leila V MacBean, Mala Ramu, Susan Reiber, Ruth Strapp, Christina Tieszer, Hans J Kreder, David J G Stephen, Terry S Axelrod, Albert J M Yee, Robin R Richards, Joel Finkelstein, Wade Gofton, John Murnaghan, Joseph Schatztker, Michael Ford, Beverly Bulmer, Lisa Conlan, G Yves Laflamme, Gregory Berry, Pierre Beaumont, Pierre Ranger, Georges-Henri Laflamme, Sylvain Gagnon, Michel Malo, Julio Fernandes, Marie-France Poirier, Emil H Schemitsch, Michael D McKee, James P Waddell, Earl R Bogoch, Timothy R Daniels, Robert R McBroom, Milena R Vicente, Wendy Storey, Lisa M, Robert McCormack, Bertrand Perey, Thomas J Goetz, Graham Pate, Murray J Penner, Kostas Panagiotopoulos, Shafique Pirani, Ian G Dommisse, Richard L Loomer, Trevor Stone, Karyn Moon, Mauri Zomar, Lawrence X Webb, Robert D Teasdall, John Peter Birkedal, David Franklin Martin, David S Ruch, Douglas J Kilgus, David C Pollock, Mitchel Brion Harris, Ethan Ron Wiesler, William G Ward, Jeffrey Scott Shilt, Andrew L Koman, Gary G Poehling, Brenda Kulp, Paul Tornetta 3rd, William R Creevy, Andrew B Stein, Christopher T Bono, Thomas A Einhorn, T Desmond Brown, Donna Pacicca, John B Sledge 3rd, Timothy E Foster, Ilva Voloshin, Jill Bolton, Hope Carlisle, Lisa Shaughnessy, William T Obremskey, C Michael LeCroy, Eric G Meinberg, Terry M Messer, William L Craig 3rd, Douglas R Dirschl, Robert Caudle, Tim Harris, Kurt Elhert, William Hage, Robert Jones, Luis Piedrahita, Paul O Schricker, Robin Driver, Jean Godwin, William T Obremskey, Philip James Kregor, Gregory Tennent, Lisa M Truchan, Marcus Sciadini, Franklin D Shuler, Robin E Driver, Mary Alice Nading, Jacky Neiderstadt, Alexander R Vap, Heather A Vallier, Brendan M Patterson, John H Wilber, Roger G Wilber, John K Sontich, Timothy Alan Moore, Drew Brady, Daniel R Cooperman, John A Davis, Beth Ann Cureton, Scott Mandel, R Douglas Orr, T S Sadler, Tousief Hussain, Krishan Rajaratnam, Bradley Petrisor, Mohit Bhandari, Brian Drew, Drew A Bednar, Desmond C H Kwok, Shirley Pettit, Jill Hancock, Natalie Sidorkewicz, Peter A Cole, Joel J Smith, Gregory A Brown, Thomas A Lange, John G Stark, Bruce A Levy, Marc F Swiontkowski, Mary J Garaghty, Joshua G Salzman, Carol A Schutte, Linda Tastad, Sandy Vang, David Seligson, Craig S Roberts, Arthur L Malkani, Laura Sanders, Carmen Dyer, Jessica Heinsen, Langan Smith, Sudhakar Madanagopal, Linda Frantz-Bush, Kevin J Coupe, Jeffrey J Tucker, Allen R Criswell, Rosemary Buckle, Alan Jeffrey Rechter, Dhiren Shaskikant Sheth, Brad Urquart, Thea Trotscher, Mark J Anders, Joseph M Kowalski, Marc S Fineberg, Lawrence B Bone, Matthew J Phillips, Bernard Rohrbacher, Philip Stegemann, William M Mihalko, Cathy Buyea, Stephen J Augustine, William Thomas Jackson, Gregory Solis, Sunday U Ero, Daniel N Segina, Hudson B Berrey, Samuel G Agnew, Michael Fitzpatrick, Lakina C Campbell, Lynn Derting, June McAdams, J Carel Goslings, Kees Jan Ponsen, Jan Luitse, Peter Kloen, Pieter Joosse, Jasper Winkelhagen, Raphaël Duivenvoorden, David C Teague, Joseph Davey, J Andy Sullivan, William J J Ertl, Timothy A Puckett, Charles B Pasque, John F Tompkins 2nd, Curtis R Gruel, Paul Kammerlocher, Thomas P Lehman, William R Puffinbarger, Kathy L Carl, Donald W Weber, Nadr M Jomha, Gordon R Goplen, Edward Masson, Lauren A Beaupre, Karen E Greaves, Lori N Schaump, Kyle J Jeray, David R Goetz, David E Westberry, J Scott Broderick, Bryan S Moon, Stephanie L Tanner, James N Powell, Richard E Buckley, Leslie Elves, Stephen Connolly, Edward P Abraham, Trudy Steele, Thomas Ellis, Alex Herzberg, George A Brown, Dennis E Crawford, Robert Hart, James Hayden, Robert M Orfaly, Theodore Vigland, Maharani Vivekaraj, Gina L Bundy, Theodore Miclau 3rd, Amir Matityahu, R Richard Coughlin, Utku Kandemir, R Trigg McClellan, Cindy Hsin-Hua Lin, David Karges, Kathryn Cramer, J Tracy Watson, Berton Moed, Barbara Scott, Dennis J Beck, Carolyn Orth, David Puskas, Russell Clark, Jennifer Jones, Kenneth A Egol, Nader Paksima, Monet France, Eugene K Wai, Garth Johnson, Ross Wilkinson, Adam T Gruszczynski, Liisa Vexler, Jason W Busse, Mohit Bhandari, Gordon H Guyatt, Diane Heels-Ansdell, Abhaya V Kulkarni, Scott Mandel, David Sanders, Emil Schemitsch, Mark Swiontkowski, Paul Tornetta 3rd, Eugene Wai, Stephen D Walter, SPRINT Investigators & the Medically Unexplained Syndromes Study Group, Mohit Bhandari, Gordon Guyatt, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta, Stephen Walter, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta 3rd, Stephen Walter, Gordon Guyatt, Mohit Bhandari, David W Sanders, Emil H Schemitsch, Marc Swiontkowski, Paul Tornetta 3rd, Stephen Walter, Sheila Sprague, Diane Heels-Ansdell, Lisa Buckingham, Pamela Leece, Helena Viveiros, Tashay Mignott, Natalie Ansell, Natalie Sidorkewicz, Julie Agel, Claire Bombardier, Jesse A Berlin, Michael Bosse, Bruce Browner, Brenda Gillespie, Alan Jones, Peter O'Brien, Julie Agel, Sheila Sprague, Rudolf Poolman, Mohit Bhandari, David W Sanders, Mark D Macleod, Timothy Carey, Kellie Leitch, Stuart Bailey, Kevin Gurr, Charlene Bartha, Isolina Low, Leila V MacBean, Mala Ramu, Susan Reiber, Ruth Strapp, Christina Tieszer, Hans J Kreder, David J G Stephen, Terry S Axelrod, Albert J M Yee, Robin R Richards, Joel Finkelstein, Wade Gofton, John Murnaghan, Joseph Schatztker, Michael Ford, Beverly Bulmer, Lisa Conlan, G Yves Laflamme, Gregory Berry, Pierre Beaumont, Pierre Ranger, Georges-Henri Laflamme, Sylvain Gagnon, Michel Malo, Julio Fernandes, Marie-France Poirier, Emil H Schemitsch, Michael D McKee, James P Waddell, Earl R Bogoch, Timothy R Daniels, Robert R McBroom, Milena R Vicente, Wendy Storey, Lisa M, Robert McCormack, Bertrand Perey, Thomas J Goetz, Graham Pate, Murray J Penner, Kostas Panagiotopoulos, Shafique Pirani, Ian G Dommisse, Richard L Loomer, Trevor Stone, Karyn Moon, Mauri Zomar, Lawrence X Webb, Robert D Teasdall, John Peter Birkedal, David Franklin Martin, David S Ruch, Douglas J Kilgus, David C Pollock, Mitchel Brion Harris, Ethan Ron Wiesler, William G Ward, Jeffrey Scott Shilt, Andrew L Koman, Gary G Poehling, Brenda Kulp, Paul Tornetta 3rd, William R Creevy, Andrew B Stein, Christopher T Bono, Thomas A Einhorn, T Desmond Brown, Donna Pacicca, John B Sledge 3rd, Timothy E Foster, Ilva Voloshin, Jill Bolton, Hope Carlisle, Lisa Shaughnessy, William T Obremskey, C Michael LeCroy, Eric G Meinberg, Terry M Messer, William L Craig 3rd, Douglas R Dirschl, Robert Caudle, Tim Harris, Kurt Elhert, William Hage, Robert Jones, Luis Piedrahita, Paul O Schricker, Robin Driver, Jean Godwin, William T Obremskey, Philip James Kregor, Gregory Tennent, Lisa M Truchan, Marcus Sciadini, Franklin D Shuler, Robin E Driver, Mary Alice Nading, Jacky Neiderstadt, Alexander R Vap, Heather A Vallier, Brendan M Patterson, John H Wilber, Roger G Wilber, John K Sontich, Timothy Alan Moore, Drew Brady, Daniel R Cooperman, John A Davis, Beth Ann Cureton, Scott Mandel, R Douglas Orr, T S Sadler, Tousief Hussain, Krishan Rajaratnam, Bradley Petrisor, Mohit Bhandari, Brian Drew, Drew A Bednar, Desmond C H Kwok, Shirley Pettit, Jill Hancock, Natalie Sidorkewicz, Peter A Cole, Joel J Smith, Gregory A Brown, Thomas A Lange, John G Stark, Bruce A Levy, Marc F Swiontkowski, Mary J Garaghty, Joshua G Salzman, Carol A Schutte, Linda Tastad, Sandy Vang, David Seligson, Craig S Roberts, Arthur L Malkani, Laura Sanders, Carmen Dyer, Jessica Heinsen, Langan Smith, Sudhakar Madanagopal, Linda Frantz-Bush, Kevin J Coupe, Jeffrey J Tucker, Allen R Criswell, Rosemary Buckle, Alan Jeffrey Rechter, Dhiren Shaskikant Sheth, Brad Urquart, Thea Trotscher, Mark J Anders, Joseph M Kowalski, Marc S Fineberg, Lawrence B Bone, Matthew J Phillips, Bernard Rohrbacher, Philip Stegemann, William M Mihalko, Cathy Buyea, Stephen J Augustine, William Thomas Jackson, Gregory Solis, Sunday U Ero, Daniel N Segina, Hudson B Berrey, Samuel G Agnew, Michael Fitzpatrick, Lakina C Campbell, Lynn Derting, June McAdams, J Carel Goslings, Kees Jan Ponsen, Jan Luitse, Peter Kloen, Pieter Joosse, Jasper Winkelhagen, Raphaël Duivenvoorden, David C Teague, Joseph Davey, J Andy Sullivan, William J J Ertl, Timothy A Puckett, Charles B Pasque, John F Tompkins 2nd, Curtis R Gruel, Paul Kammerlocher, Thomas P Lehman, William R Puffinbarger, Kathy L Carl, Donald W Weber, Nadr M Jomha, Gordon R Goplen, Edward Masson, Lauren A Beaupre, Karen E Greaves, Lori N Schaump, Kyle J Jeray, David R Goetz, David E Westberry, J Scott Broderick, Bryan S Moon, Stephanie L Tanner, James N Powell, Richard E Buckley, Leslie Elves, Stephen Connolly, Edward P Abraham, Trudy Steele, Thomas Ellis, Alex Herzberg, George A Brown, Dennis E Crawford, Robert Hart, James Hayden, Robert M Orfaly, Theodore Vigland, Maharani Vivekaraj, Gina L Bundy, Theodore Miclau 3rd, Amir Matityahu, R Richard Coughlin, Utku Kandemir, R Trigg McClellan, Cindy Hsin-Hua Lin, David Karges, Kathryn Cramer, J Tracy Watson, Berton Moed, Barbara Scott, Dennis J Beck, Carolyn Orth, David Puskas, Russell Clark, Jennifer Jones, Kenneth A Egol, Nader Paksima, Monet France, Eugene K Wai, Garth Johnson, Ross Wilkinson, Adam T Gruszczynski, Liisa Vexler
Abstract
Objective: To explore the role of patients' beliefs in their likelihood of recovery from severe physical trauma.
Methods: We developed and validated an instrument designed to capture the impact of patients' beliefs on functional recovery from injury: the Somatic Pre-Occupation and Coping (SPOC) questionnaire. At 6-weeks postsurgical fixation, we administered the SPOC questionnaire to 359 consecutive patients with operatively managed tibial shaft fractures. We constructed multivariable regression models to explore the association between SPOC scores and functional outcome at 1 year as measured by return to work and Short Form-36 (SF-36) physical component summary and mental component summary scores.
Results: In our adjusted multivariable regression models that included preinjury SF-36 scores, SPOC scores at 6 weeks postsurgery accounted for 18% of the variation in SF-36 physical component summary scores and 18% of SF-36 mental component summary scores at 1 year. In both models, 6-week SPOC scores were a far more powerful predictor of functional recovery than age, gender, fracture type, smoking status, or the presence of multitrauma. Our adjusted analysis found that for each 14-point increment in SPOC score at 6 weeks (14 chosen on the basis of half a standard deviation of the mean SPOC score), the odds of returning to work at 1 year decreased by 40% (odds ratio, 0.60; 95% confidence interval, 0.50-0.73).
Conclusion: The SPOC questionnaire is a valid measurement of illness beliefs in patients with tibial fracture and is highly predictive of their long-term functional recovery. Future research should explore if these results extend to other trauma populations and if modification of unhelpful illness beliefs is feasible and would result in improved functional outcomes.
Trial registration: ClinicalTrials.gov NCT00038129.
Source: PubMed