Acute Injury of Upper Extremity Clinical Trial
Official title:
Impact of Keeping a Personal Recovery Diary on Upper Extremity Disability
Primary null hypothesis:
• Keeping a personal diary has no effect on upper-extremity disability (assessed w/ PROMIS
[Patient Reported Outcome Measurement Information System] upper extremity) 8 weeks after
injury.
Secondary null hypotheses:
- Keeping a personal diary has no effect on avoidance of painful activities (assessed w/
PROMIS pain interference) 8 weeks after injury.
- Keeping a personal diary has no effect on symptoms of depression (assessed w/ PROMIS
depression) 8 weeks after injury.
- There are no factors associated with upper-extremity disability 8 weeks after injury.
Recovery from injury can be counterintuitive and taxing. It is natural to feel protective
and prepare for the worst. Healthy exercises can seem unwise. It can seem like things are
taking too long or getting off track. We have noticed that small improvements such as being
able to resume a cherished activity (e.g. knitting or swimming) or achieving some success
with exercises (e.g. obtaining full supination after fracture of the distal radius), can
help patients feel like things are going to be okay. That feeling seems to make it easier to
do exercises and resume function activities.
We wonder if awareness of this process (mindfulness) would help patients recover more
rapidly. Keeping a journal is one method for encouraging mindfulness. It allows patients to
express themselves and tell their stories. There is evidence that such "narrative medicine"
can be healing. We anticipate that patients who perceive little or no progress will be able
to look back on how they were feeling earlier on and appreciate that things are moving in
the right direction. We also hope that their journal material might be useful for other
patients that are having trouble seeing the "light at the end of the tunnel", so as part of
this study, we will get permission to use their quotes anonymously in future patient care
materials and future research. To our knowledge, research on the impact of keeping a
personal diary/journal of recovery is scant, particularly pertaining to recovery from upper
extremity trauma.
Explanatory variables:
- Diary or no Diary
- Diagnosis (fracture, sprain, contusion, skin laceration, complex laceration [tendon,
nerve])
- Location (hand, wrist, forearm, elbow, arm, shoulder)
- Sex
- Age
- Education
- Work status
- Insurance (worker's compensation, private, public, other)
- Visit type
- Prior treatment received
- Other pain conditions
- Smoking status
- Marital status
- Physical or Occupational Therapy
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment