Evaluation of Psychosocial Factors Influencing Recovery From Orthopaedic Trauma

Publication Date: October 21, 2021
Last Updated: March 14, 2022

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

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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

Publication Month/Year

October 21, 2021

Last Updated Month/Year

July 24, 2023

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

Physical therapist, nurse, nurse practitioner, 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.

Supplemental Methodology Resources

Data Supplement