- •Possible factors affecting orthosis adherence were evaluated by using the multidimensional adherence model.
- •Only one-third of the patients with acute traumatic tendon repair were fully adherent with the orthosis wear program.
- •Depression in the very acute period of injury impaired orthosis adherence.
Custom-made orthoses are used to prevent contractures and reinjury of tissues such as tendon rupture after traumatic tendon repairs. Despite their wide usage in hand rehabilitation, orthosis adherence is usually an overlooked problem.
Purpose of the Study
This study aims to evaluate the possible factors affecting the orthosis adherence in patients with acute traumatic tendon repairs.
This is a prospective cohort study.
Two hundred twelve patients with acute traumatic hand tendon repair were included in this prospective cohort study. Patients were evaluated on the third day postoperatively and at three weeks. All patients were told to wear their orthosis 24 h a day for three weeks and allowed to take it off to wash the hand carefully once a day. Adherence was measured as fully adherent, partially adherent, and nonadherent. Factors that may affect orthosis adherence were evaluated according to the five dimensions of the multidimensional adherence model including socioeconomic, condition-related, treatment-related, patient-related, and health-care system–related factors. The Modified Hand Injury Severity Scale was used to assess the severity of the injury. Depression and anxiety symptoms were evaluated with the Beck Depression Inventory and Beck Anxiety Inventory. A multivariate logistic regression model was constructed for orthosis adherence.
One hundred thirty-three patients were analyzed. Forty-four (33.1%) patients were fully adherent with the prescribed orthosis, whereas 67 (50.4%) were partially adherent and 22 (16.5%) were nonadherent. Higher depression symptoms caused orthosis nonadherence [odds ratio = 1.2 (95% confidence interval = 1.1-1.3), P = .001] and partial adherence [odds ratio = 1.1 (95% confidence interval = 1.0-1.2), P = .01].
Among our patients with acute traumatic tendon repair, only one-third of the patients were fully adherent with the orthosis wear program. Depression in the very acute period of injury impaired orthosis adherence.
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JHT Read for Credit
Quiz: # 808
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 JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- b.case series
- c.prospective cohort
- # 2.How many patients were fully compliant to their orthosis wearing regiment?
- # 3.The authors felt that __________ in the patients was a significant factor in non-compliance to the orthosis wearing regiment
- a.lack of understanding
- b.inadequate funding
- # 4.The WHO’s MAM was designed to help understand reasons affecting
- a.patient education
- b.staff coordination
- c.adherence to medical regiments (e.g. orthosis wearing schedules)
- d.orthosis designs in hand injury populations
- # 5.Due to the low level of patient compliance to orthosis wearing, the authors recommend plaster immobilization in a protected position for 4-6 weeks immediately following tendon repair.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Published online: October 16, 2020
Accepted: October 9, 2020
Received in revised form: September 17, 2020
Received: October 4, 2019
Conflict of interest: None.
© 2020 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.