Scientific/Clinical Article| Volume 31, ISSUE 4, P502-510, October 2018

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Adjustment to hand injury: Cross-sectional survey exploring adjustment in relation to illness perceptions and coping strategies


      Study Design

      Cross-sectional descriptive.


      Hand injuries are highly prevalent, and the impact they have on physical, emotional, and functional adjustment is well recognized. Increasingly, adjustment to health conditions including hand injuries is being understood in terms of psychological variables.

      Purpose of the Study

      To examine the role of illness beliefs and coping strategies in adjustment to hand injury. Adjustment was considered from a complete perspective including quality of life (QOL) and functional ability as well as mood and trauma symptoms.


      Cross-sectional survey whereby consecutive patients (n = 65) attending the regional plastic surgery service with hand injuries were invited to complete a questionnaire assessing illness perceptions, coping strategies, QOL, hand functioning, depression, and trauma symptoms. Data were analyzed in SPSS (IBM Corporation, Armonk, NY) by correlation and then hierarchical regression analysis.


      Illness perceptions and coping strategies were significantly related to the adjustment outcomes (hand functioning, QOL, depression, and trauma symptoms). Specifically, poorer adjustment was associated with more negative illness beliefs (r = 0.31-0.47), greater use of denial (r = 0.24-0.53), and avoidance-based (r = 0.41-0.64) coping strategies.


      Illness beliefs and coping play an important role in adjustment after hand injury. Adjustment is multifaceted with a need to consider physical and emotional functioning. More optimistic beliefs and adaptive coping styles are associated with improved adjustment.


      The role of psychological variables in optimizing adjustment is an important consideration for the design of psychological interventions, but because this study was cross sectional and cannot assume directional effects, future longitudinal studies are needed.

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      JHT Read for Credit

      Quiz: #574

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        Data for this cross sectional survey was mined from
        • a.
          chart reviews
        • b.
          patient interviews
        • c.
          patient questionnaires
        • d.
          therapists questionnaires
      • #2.
        Adjustment was considered
        • a.
          as a holistic concept
        • b.
          on the basis of hand function
        • c.
          on the basis of its emotional impact
        • d.
          from a WHO definition
      • #3.
        There were __________ participants/subjects
        • a.
        • b.
        • c.
        • d.
      • #4.
        Due to the study design
        • a.
          the results cannot be applied across national/state borders
        • b.
          it requires a PhD to fully comprehend the results
        • c.
          no cause and effect could be determined
        • d.
          the results are useful to hand therapists, but not hand surgeons
      • #5.
        Medical and demographic factors were shown to be the primary factors affecting adjustment
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.