Publications by authors named "Abby Cheng"
Background: Therapeutic lifestyle change can be challenging, and not every attempt is successful.
Purpose: To identify predictors of making progress toward lifestyle change among patients who participate in a lifestyle medicine program.
Methods: This was a single-center, retrospective cohort study of 205 adults who enrolled in a goal-directed, individualized, interprofessional lifestyle medicine program.
Background: Changes in lifestyle habits can reduce morbidity and mortality, but not everyone who can benefit from lifestyle intervention is ready to do so.
Purpose: To describe characteristics of patients who did and did not engage with a lifestyle medicine program, and to identify predictors of engagement.
Methods: This was a single-center, retrospective cohort study of 276 adult patients who presented for consultation to a goal-directed, individualized, interprofessional lifestyle medicine program.
Article Synopsis
- - The study investigates whether patients with high anxiety (PROMIS scores >95th percentile) undergo elective hand surgery at different rates compared to patients with lower anxiety levels, while also assessing how surgeons document these patients' emotional states and report postoperative complications.
- - Using data from adult patients seeking hand care between 2019 and 2020, the research categorized patients based on anxiety levels and compared surgical outcomes between high anxiety burden (HAB) patients and matched controls, finding significant differences in surgery rates and complications.
- - Results show that while both groups were offered surgery at similar rates, HAB patients were less likely to proceed with surgery and experienced more complications, suggesting that surgeons may often overlook the emotional well-being of high anxiety patients in
Article Synopsis
- Preliminary findings indicate that the digital mental health intervention Wysa for Chronic Pain may enhance both mental and physical well-being in individuals experiencing chronic musculoskeletal pain and symptoms of depression or anxiety.
- The study aimed to explore the behavioral mechanisms—specifically behavioral activation, pain acceptance, and sleep quality—that might link the use of Wysa to better mental and physical health outcomes.
- In a pilot mediation analysis involving 30 participants, results suggested that higher engagement with the Wysa intervention led to improved mental health outcomes, particularly through the mediating effect of behavioral activation.
Aim: Little is known about the relationship between personal factors and perception of hip-related function among patients with chronic hip-related groin pain (HRGP) seeking non-operative management. This analysis was performed to determine if depressive symptoms, central sensitisation, movement evoked pain (MEP), pressure hypersensitivity and activity level were associated with patients' perception of hip-related function, represented by the International Hip Outcome Tool (iHOT-33).
Methods: This cross-sectional study used baseline data from a pilot randomised clinical trial.
Article Synopsis
- - The evaluation and treatment of hip pain in adolescents and young adults have advanced significantly, particularly regarding common issues like labral tears linked to bony abnormalities.
- - Conditions such as femoroacetabular impingement (FAI) and acetabular dysplasia are now recognized as major contributors to hip osteoarthritis, with early treatment aimed at reducing symptoms and extending hip health.
- - A multidisciplinary, team-based approach to managing hip disorders in this age group has proven effective, emphasizing the need for expert conservative management techniques like physical therapy alongside surgical and postoperative care.
Importance: Among patients seeking care for musculoskeletal conditions, there is mixed evidence regarding whether traditional, structure-based care is associated with improvement in patients' mental health.
Objective: To determine whether improvements in physical function and pain interference are associated with meaningful improvements in anxiety and depression symptoms among patients seeking musculoskeletal care.
Design, Setting, And Participants: This cohort study included adult patients treated by an orthopedic department of a tertiary care US academic medical center from June 22, 2015, to February 9, 2022.
Background: Although depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders' perceptions regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care.
Methods: This single-center, qualitative study was conducted within a tertiary care orthopedic department.
Article Synopsis
- The study aimed to evaluate how effective nonoperative treatments are for patients with nonarthritic hip pain, focusing on the response rates and the role of physical therapy among other treatments.
- Researchers analyzed data from 26 studies involving 1,153 patients to determine the overall effectiveness, finding a 54% response rate to treatment.
- While physical therapy showed some improvement in pain and symptoms, the specific impact of different therapy types or durations wasn’t clear, and other methods like injections showed very low to low certainty in effectiveness.
Importance: Among patients seeking care for musculoskeletal conditions, there is mixed evidence regarding whether traditional, structure-based care is associated with improvement in patients' mental health.
Objective: To determine whether improvements in physical function and pain interference are associated with meaningful improvements in anxiety and depression symptoms among patients seeking musculoskeletal care.
Design: Retrospective cohort study from June 22, 2015 to February 9, 2022.
Background: Although depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders' perspectives regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care.
Methods: This single-center, qualitative study was conducted within the orthopedic department of a tertiary care center.
Unlabelled: There is growing awareness among orthopaedic clinicians that mental health directly impacts clinical musculoskeletal outcomes. The Patient-Reported Outcomes Measurement Information System (PROMIS) is increasingly used for mental health screening in this context, but proper interpretation of patient scores remains unclear. The purpose of the present study was to compare musculoskeletal patients' PROMIS Depression and Anxiety scores with a board-certified clinical psychologist's assessment of their depression and/or anxiety diagnoses, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.
View Article and Find Full Text PDFArticle Synopsis
- The study highlights the connection between mental health issues like depression and anxiety and poorer patient satisfaction and outcomes in orthopaedic treatment, indicating a growing awareness but lack of focus on mental health in clinical training.
- It investigates the perceptions, motivators, barriers, and facilitators related to incorporating mental health care into orthopaedic practices from the perspectives of both patients and healthcare providers.
- The research was conducted through semistructured interviews with 30 patients who had long-term neck or back pain, aiming to identify practical strategies to effectively address mental health in orthopaedic care settings.
Interprofessional care improves outcomes for medically complex patients and may be a valuable addition to standard lifestyle medicine practice, but implementation barriers exist. The purpose of this study was to explore the key features, perceived impact, and implementation considerations related to holding interprofessional team meetings as part of an intensive lifestyle medicine program. In this mixed-methods study, focus groups were conducted with 15 lifestyle medicine clinicians from various healthcare disciplines who had participated in interprofessional team meetings.
View Article and Find Full Text PDFBackground: Mobile health (mHealth) apps offer new opportunities to deliver psychological treatments for mental illness in an accessible, private format. The results of several previous systematic reviews support the use of app-based mHealth interventions for anxiety and depression symptom management. However, it remains unclear how much or how long the minimum treatment "dose" is for an mHealth intervention to be effective.
View Article and Find Full Text PDFBackground: This study investigated the utility of depression and anxiety symptom screening in patients scheduled for total knee arthroplasty to examine differences in active symptoms according to patients' mental health diagnoses and associated prescription medications.
Material And Methods: This cross-sectional study analyzed 594 patients scheduled for total knee arthroplasty at a tertiary practice between June 2018 and December 2018. Patients completed Patient-Reported Outcomes Measurements Information System (PROMIS) Depression and Anxiety Computerized Adaptive Tests in clinic quantifying active symptoms.
Introduction: Factors that motivate musculoskeletal patients to pursue an intensive, lifestyle medicine-based approach to care are poorly understood.
Objective: To determine whether, compared to patients seeking musculoskeletal care through traditional pathways, patients who choose an intensive lifestyle medicine program for musculoskeletal pain endorse greater physical dysfunction, worse psychological health, and/or more biopsychosocial comorbidities.
Design: Cross-sectional analysis of existing medical records from 2018 to 2021.
Background: Digital applications are commonly used to support mental health and well-being. However, successfully retaining and engaging users to complete digital interventions is challenging, and comorbidities such as chronic pain further reduce user engagement. Digital conversational agents (CAs) may improve user engagement by applying engagement principles that have been implemented within in-person care settings.
View Article and Find Full Text PDFBackground: Depression and anxiety frequently coexist with chronic musculoskeletal pain and can negatively impact patients' responses to standard orthopedic treatments. Nevertheless, mental health is not routinely addressed in the orthopedic care setting. If effective, a digital mental health intervention may be a feasible and scalable method of addressing mental health in an orthopedic setting.
View Article and Find Full Text PDFBackground: Symptoms of depression and anxiety commonly coexist with chronic musculoskeletal pain, and when this occurs, standard orthopedic treatment is less effective. However, mental health intervention is not yet a routine part of standard orthopedic treatment, in part because of access-related barriers. Digital mental health intervention is a potential scalable resource that could be feasibly incorporated into orthopedic care.
View Article and Find Full Text PDFBackground: Extensive literature has described surgical outcomes for pre-arthritic hip pain, but the proportion of patients who progress to surgery remains unknown.
Objective: To determine the proportion of patients who present to a tertiary referral center for pre-arthritic hip pain and progress to surgery at minimum 1-year follow-up.
Design: Retrospective cohort study.
How Should We Measure Social Deprivation in Orthopaedic Patients?
Clin Orthop Relat Res
February 2022
Background: Social deprivation negatively affects a myriad of physical and behavioral health outcomes. Several measures of social deprivation exist, but it is unclear which measure is best suited to describe patients with orthopaedic conditions.
Questions/purposes: (1) Which measure of social deprivation, defined as "limited access to society's resources due to poverty, discrimination, or other disadvantage," is most strongly and consistently correlated with patient-reported physical and behavioral health in patients with orthopaedic conditions? (2) Compared with the use of a single measure alone, how much more variability in patient-reported health does the simultaneous use of multiple social deprivation measures capture?
Methods: Between 2015 and 2017, a total of 79,818 new patient evaluations occurred within the orthopaedic department of a single, large, urban, tertiary-care academic center.
Background: Lifestyle factors are associated with musculoskeletal pain and metabolic chronic diseases. To date, intensive lifestyle medicine programs have predominantly targeted metabolic rather than musculoskeletal conditions.
Objective: To assess the feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions.