Hand and wrist problems in general practice--patient characteristics and factors related to symptom severity.
OBJECTIVE
Hand and wrist problems are common, but little is known about characteristics of patients consulting the general practitioner (GP) for these problems. The objectives are: (i) to describe wrist and hand problems presented to the GP in terms of severity of symptoms, and their impact on physical, emotional and social functioning; (ii) to describe patient and disease characteristics across different diagnostic categories; and (iii) to study factors related to the severity of hand or wrist problems.


METHODS
Patients consulting their GP with hand or wrist problems were sent a questionnaire containing questions on socio-demographic variables, characteristics of the complaint, physical activity and psychosocial factors. The GP recorded information on symptoms, signs and medical diagnosis. We studied the cross-sectional association between a variety of factors and severity of hand or wrist problems, using the Symptom Severity Scale as the outcome measure.


RESULTS
Mean age of the 267 participants was 49.3 yrs and 74% were female. The three most frequently recorded diagnoses were osteoarthritits (17%), tenosynovitis (16%) and nerve entrapment (12%). The characteristics of patients varied slightly across diagnostic categories. Patients who did not have paid work, had longer duration of symptoms, diagnosis of entrapment, higher pain intensity, higher body mass index and higher scores on worrying reported significantly higher scores on severity of hand or wrist problems (P-value <0.10).


CONCLUSIONS
Primary care patients with hand or wrist problems report pain and reduced function. Impact on other aspects of perceived health is limited. Severity seems to be associated with socio-demographic, physical and psychosocial factors, more than with medical diagnosis.
Spies-Dorgelo
M N
MN
Department of General Practice, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. mn.spies@vumc.nl
van der Windt
D A W M
DA
van der Horst
H E
HE
Prins
A P A
AP
Stalman
W A B
WA
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D050823:Hand Joints; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000209:etiology; D009408:Nerve Compression Syndromes / Q000175:diagnosis; D010003:Osteoarthritis / Q000175:diagnosis; D010146:Pain / Q000523:psychology; D012720:Severity of Illness Index; D013717:Tenosynovitis / Q000175:diagnosis; D014955:Wrist Joint