Evaluation of Psychosocial Factors Influencing Recovery From Orthopaedic Trauma
Recommendations
It is recommended that clinicians evaluate the following factors because they are associated with increased biopsychosocial limitations after adult orthopaedic trauma:
- Anxiety
- Posttraumatic stress disorder
- Depression
- Premorbid psychiatric conditions
- Smoking
- Lower education level
- Less social support
- Resilience issues (ie, limited self-efficacy and less effective coping strategies)
Strength of recommendation: Moderate.
Implication: Practitioners should generally follow a moderate recommendation but remain alert to new information and be sensitive to patient preferences.
Recommendation Grading Table
|
Strength of Recommendation
|
Overall Strength of Evidence | Description of Evidence quality |
| Strong | Strong | Evidence from two or more “high”-quality studies with consistent findings for recommending for or against the intervention. In addition, it requires no reasons to downgrade from the EtD framework. |
| Moderate | Moderate or strong | Evidence from two or more “moderate”-quality studies with consistent findings or evidence from a single “high”-quality study for recommending for or against the intervention. In addition, it requires no or only minor concerns addressed in the EtD framework. |
| Limited | Limited, moderate, or strong | Evidence from one or more “low”-quality studies with consistent findings or evidence from a single “moderate”-quality study recommending for or against the intervention. In addition, higher strength evidence can be downgraded to limited because of major concerns addressed in the EtD framework. |
| Consensus | No reliable evidence | No supporting evidence exists, or higher quality evidence was downgraded because of major concerns addressed in the EtD framework. In the absence of reliable evidence, the guideline work group is making a recommendation based on their clinical opinion. |
Recommendation Grading
Overview
Title
Evaluation of Psychosocial Factors Influencing Recovery From Orthopaedic Trauma
Authoring Organization
American Academy of Orthopaedic Surgeons
Publication Month/Year
October 20, 2021
Last Updated Month/Year
August 29, 2024
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
US
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Home health, Long term care, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physical therapist, physician, physician assistant
Scope
Management, Rehabilitation
Diseases/Conditions (MeSH)
D012046 - Rehabilitation, D010810 - Physical and Rehabilitation Medicine, D020127 - Recovery of Function, D000080482 - Enhanced Recovery After Surgery, D009104 - Multiple Trauma
Keywords
orthopedic surgery, adult orthopaedic trauma, orthopaedic trauma
Source Citation
Keizer BM, Wegener ST. AAOS/Major Extremity Trauma and Rehabilitation Consortium Clinical Practice Guideline Summary for Evaluation of Psychosocial Factors Influencing Recovery From Orthopaedic Trauma. J Am Acad Orthop Surg. 2021 Oct 25. doi: 10.5435/JAAOS-D-21-00777. Epub ahead of print. PMID: 34714783.