Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?
Patients with workers' compensation claims have worse outcomes after rotator cuff repair.
BACKGROUND Previous studies have demonstrated varying correlations between Workers ' Compensation status and the outcome of rotator cuff repair . However , none of those studies have formally accounted for potential confounding factors with multivariable analysis . We hypothesized that patients with Workers ' Compensation cl aims who undergo rotator cuff repair have worse outcomes , even after controlling for confounding factors . METHODS One hundred and twenty-five patients ( including thirty-nine with Workers ' Compensation cl aims ) who underwent unilateral primary repair of a chronic rotator cuff tear by a single surgeon were studied prospect ively and were evaluated one year postoperatively , prior to the settlement of any cl aims . Outcomes were assessed with the  Simple Shoulder Test ( SST ) ; the Disabilities of the Arm , Shoulder and H and ( DASH ) index ; three visual analog scales ( shoulder pain , shoulder function , and quality of life ) ; and the Short Form-36 ( SF-36 ) . RESULTS Patients in the Workers ' Compensation group were significantly younger , had greater work dem and s , and had lower marital rates , education levels , and preoperative expectations for the outcome of treatment as compared with those in the non-Workers ' Compensation group ( p = 0.001 to 0.016 ) . Preoperatively , patients in the Workers ' Compensation group had significantly lower scores on the SST , the SF-36 Physical Function scale , and the SF-36 Social Function scale ( p = 0.01 to 0.038 ) . One year postoperatively , those patients reported worse performance on the SST , the DASH , all three visual analog scales , and the SF-36 ( p = 0.0007 to 0.05 ) and had worse improvement on the DASH , the visual analog scales for shoulder pain and function , and the SF-36 Bodily Pain and Role Emotional scales ( p = 0.0028 to 0.038 ) . Multivariable analysis controlling for age , sex , comorbidities , smoking , marital status , education , duration of symptoms , work dem and s , expectations , and tear size confirmed that Workers ' Compensation status was an independent predictor of worse DASH scores . CONCLUSIONS Patients with Workers ' Compensation cl aims report worse outcomes , even after controlling for confounding factors . The present study provides further evidence that the existence of a Workers ' Compensation cl aim portends a less robust outcome following rotator cuff repair . LEVEL OF EVIDENCE Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence
Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?