Correlation between anxiety, depression, sense of coherence, and post-traumatic growth in patients who underwent intertrochanteric femoral fracture surgery

Abstract

Background: Postoperative anxiety, depression, irritability, and even fear in patients with intertrochanteric femoral fractures may hinder recovery, compromise treatment efficacy, and impede rehabilitation.

Aim: To investigate the correlations among anxiety, depression, sense of coherence (SOC), and post-traumatic growth (PTG) in patients who underwent intertrochanteric femoral fracture surgery to improve clinical management strategies and outcomes.

Methods: This study carefully selected 211 patients who received surgical treatment for intertrochanteric femoral fractures and were admitted to Dongying People's Hospital from March 2022 to March 2024. Anxiety and depression in these patients were assessed with the anxiety and depression subscales of the Hospital Anxiety and Depression Scale (HADS), respectively. SOC was evaluated using the 13-item SOC scale (SOC-13), which encompasses three key dimensions: Comprehensibility, manageability, and meaningfulness. PTG was assessed with the Chinese version of PTG Inventory (CPTGI), covering five distinct dimensions: Personal strength, appreciation of life, relating to others, new possibilities, and spiritual change. The Pearson correlation coefficient was used to meticulously analyze the associations among HADS-Anxiety, HADS-Depression, SOC-13, and CPTGI. Further, univariate and multivariate analyses were conducted to identify factors that affect PTG in patients who underwent intertrochanteric femoral fracture surgery.

Results: The collected data demonstrated that 67.30% and 60.66% of the 211 patients experienced anxiety and depression, respectively, with overall anxiety levels ranging from mild to moderate and depression levels being mild. The mean SOC-13 score was 55.73 ± 8.81 points, indicating a generally low SOC level. The average CPTGI score was 54.93 ± 9.92 points, demonstrating a relatively low PTG level. Notably, both HADS-Anxiety and HADS-Depression scores were significantly negatively correlated with CPTGI, whereas SOC-13 scores were significantly positively correlated with CPTGI. Univariate and multivariate analyses identified the presence of comorbidities [odds ratio (OR) = 2.747, P = 0.003], monthly household income (OR = 3.292, P < 0.001), and exercise habits (OR = 4.651, P < 0.001) as independent predictors of PTG in patients.

Conclusion: The results of this study indicate a significant negative correlation of anxiety and depression with PTG in patients after intertrochanteric femoral fracture surgery, whereas a significant positive association exists between SOC and PTG. This study helps more comprehensively understand the psychological status and recovery processes of such patients, thereby potentially providing valuable information for clinical practice and psychological interventions.

Keywords: Anxiety; Depression; Intertrochanteric femoral fracture; Post-traumatic growth; Sense of coherence.