Highlights
- •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.
Abstract
Introduction
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.
Study Design
This is a prospective cohort study.
Methods
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.
Results
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].
Conclusions
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.
Keywords
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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
- a.RCTs
- b.case series
- c.prospective cohort
- d.qualitative
- a.
- # 2.How many patients were fully compliant to their orthosis wearing regiment?
- a.1/3
- b.1/4
- c.1/5
- d.1/10
- a.
- # 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
- c.indifference
- d.depression
- a.
- # 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
- a.
- # 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.
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: October 16, 2020
Accepted:
October 9,
2020
Received in revised form:
September 17,
2020
Received:
October 4,
2019
Footnotes
Conflict of interest: None.
Identification
Copyright
© 2020 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
