title: The correlation of phrases and feelings with disability.
abstract: BACKGROUND
  Patient expressions reflect disability and psychological factors. The aim of this study was to list common phrases and feelings in hand surgery practice and to prospectively study the correlation of these phrases and to correlate them with possible associated feelings and disability.
  
  
  METHODS
  Eighty-three patients completed the short version of the disabilities of arm, shoulder and hand (QuickDASH) questionnaire to measure disability, the pain self-efficacy questionnaire (PSEQ) to study coping, and a pain scale. The patients also completed the phrases and feelings questionnaire, which list verbal expressions patients often use. Pearson's correlation was used to test the correlation of continuous variables, and independent t test and one-way ANOVA were used for categorical variables. All variables with p < 0.08 were inserted in a multivariable regression.
  
  
  RESULTS
  There was a large correlation between the individual phrases and feelings questions with PSEQ and QuickDASH. The best model for the combined phrases questionnaire included pain, PSEQ, smoking, and other pain conditions. The best model for the combination of all the feelings questions included PSEQ, pain, and marital status. The best model for QuickDASH included phrases, PSEQ, prior treatment, and working status, with phrases being the strongest factor.
  
  
  CONCLUSIONS
  Patients use specific phrases that indicate the magnitude of their disability and the effectiveness of their coping strategies. Providers should respond to these phrases by empathetically acknowledging these aspects of the human illness experience.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
authors.forename: Pim A D
authors.initials: PA
authors.lastname: van Dijk
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA ; Harvard Medical School, Boston, USA.
authors.forename: Arjan G J
authors.initials: AG
authors.lastname: Bot
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA ; Harvard Medical School, Boston, USA.
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA ; Department of Orthopaedic Surgery, Harvard Medical School, Boston, USA.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA ; Department of Orthopaedic Surgery, Harvard Medical School, Boston, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Disability; Pain; Patient language; Self-efficacy