Adolescent scoliosis: effects of corrective surgery, cognitive-behavioral interventions, and age on activity outcomes.
The effects of spinal fusion surgery and cognitive-behavioral interventions on 88 adolescents' (11-18 years) activity outcomes were examined using a randomized trial with three intervention groups (information only, coping only, coping plus information) and a control group. The effects included a significant drop from baseline (preoperative) in usual activities and social activities at 1 month postsurgery for all groups, indicating that initially postsurgical recovery is particularly disruptive to patients' lives. At 3 months after surgery, all groups showed increased usual activities and social activities. Between the 3- and 6-month assessments, all groups had increases in social activities. Furthermore, the information only group had a significant increase in usual activities from 3 to 6 months. Younger adolescents (ages 11-14) in the combined information plus coping group and the control group had higher social scores over the postsurgery recovery period compared with those in the coping-only group. No differences were found on academic performance. The adolescents did not return to their baseline social activity levels during the 9-month recovery period (typically when long-term recovery is completed), indicating that the surgery itself has a long-term negative effect on patients' social life.
LaMontagne
Lynda L
LL
School of Nursing, Vanderbilt University, 412 Godchaux Hall, 461 21st Avenue South, Nashville, TN 37240, USA. lynda.lamontagne@vanderbilt.edu
Hepworth
Joseph T
JT
Cohen
Frances
F
Salisbury
Michele H
MH
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000704:Analysis of Variance; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D019990:Perioperative Care / Q000379:methods / Q000592:standards; D000297:Psychology, Adolescent; D020127:Recovery of Function; D012600:Scoliosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D012648:Self Care / Q000379:methods / Q000523:psychology; D012919:Social Behavior; D013123:Spinal Fusion / Q000009:adverse effects / Q000523:psychology; D013664:Teaching Materials / Q000592:standards; D016896:Treatment Outcome; D014743:Videotape Recording / Q000592:standards