Editor's Spotlight/Take 5: What Role Does Positive Psychology Play in Understanding Pain Intensity and Disability Among Patients with Hand and Upper-extremity Conditions?

摘要

How many times has each of us been told to "think positive"? Presumably never by our English teachers or copyeditors (who might prefer to say "think positively"), but no doubt countless times by friends, mentors, and coaches. And most of us probably also have noticed that doing so has generated some benefits along the way. Yet strangely, most research that connects thoughts—positive or otherwise—with the degree to which our patients achieve pain reduction or functional restoration after the operations we do has focused on those who have trouble "thinking positive" (or even "positively"). Many studies have associated endpoints like persistent disability and more severe pain after musculoskeletal injury or surgery, poorer patient-reported outcomes scores, and revision procedures with depression [9, 13, 17], anxiety [6, 13], catastrophic thinking [6], or poor coping skills [13]. By contrast, much less is known about whether patients and providers can bend the curve up by cultivating positive attitudes or habits, such as mindfulness or gratitude [1,12, 16]. In short, while thinking negatively seems to hurt, how much does it help our patients—if at all—if they "think positive"?