Evidence map›Paper›PMID 42688775›Full record

ArticleGeriatric orthopaedic surgery & rehabilitation2026

Postoperative Depression, Anxiety, and Stress in Relation to Health-Related Quality of Life Among Patients Undergoing Total Knee Replacement in Jordan.

Wael Al-Tamimi, Majdi Alhadidi, Omar Alqaisi, Mohammed Dibas, Maha Subih, Ahmad Al-Rawashdeh, Patricia Tai

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Article in Geriatric orthopaedic surgery & rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Wael Al-TamimiFaculty of Nursing, Al- Zaytoonah University of Jordan (ZUJ), Amman, Jordan.
Majdi AlhadidiFaculty of Nursing, Al- Zaytoonah University of Jordan (ZUJ), Amman, Jordan.
Omar AlqaisiNursing Department, Al-Zaytoonah University, Amman, Jordan.
Mohammed DibasDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.ORCID https://orcid.org/0009-0000-7324-264X
Maha SubihNursing Department, Al-Zaytoonah University, Amman, Jordan.
Ahmad Al-RawashdehPsychiatric Mental Health Nursing, Princess Aisha Bint Al Hussein College for Nursing, Al-Hussein Bin Talal University, Ma'an, Jordan.
Patricia TaiDepartment of Oncology, University of Saskatchewan, Saskatoon, SK, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Up to 25% of patients undergoing total knee replacement (TKR) for end-stage knee osteoarthritis report persistent pain, functional limitation, and reduced health-related quality of life (HRQoL). Although depression, anxiety, and stress are recognized determinants of surgical outcomes, their postoperative impact remains poorly studied in the Arab world, with no multicenter data from Jordan. Objectives: This study aimed to assess the postoperative depression, anxiety, and stress and their association with HRQoL among TKR patients in Jordan, and to identify independent predictors of HRQoL. Methods: A cross-sectional descriptive correlational design was used. A total of 140 adults were recruited from two government orthopedic hospitals in Jordan. Assessments were conducted at a single postoperative time point, 6-12 weeks following TKR surgery. Postoperative depression, anxiety, and stress were measured using the validated Arabic DASS-21 (α = 0.94), and HRQoL was assessed using the Arabic SF-12 (α = 0.84). Data were analyzed using descriptive statistics, Pearson correlation, and stepwise multiple linear regression. Results: Participants demonstrated moderate depression (M = 18.66, SD = 7.18) and anxiety (M = 14.13, SD = 7.63), and mild stress (M = 17.17, SD = 7.65) post-TKR. The mean HRQoL score was 39.56 (SD = 10.07). A statistically significant negative correlation was found between psychological distress and HRQoL (r = -0.27, p = 0.001). Multiple regression identified body mass index (BMI) (B = -0.382, p < 0.001) and postoperative psychological distress (DASS-21 total score; B = -0.054, p < 0.001) as independent predictors of HRQoL, explaining 17.7% of total variance. Educational level and comorbidities were significantly associated with postoperative depression, anxiety, and stress. Conclusion: Postoperative TKR patients in Jordan demonstrated poor overall HRQoL alongside moderate psychological distress. Routine psychological screening and targeted multidisciplinary interventions addressing modifiable factors such as BMI and psychological distress may help improve patient outcomes following TKR.

Indexed as

anxietyDASS-21depressionhealth-related quality of lifeorthopedic surgerypostoperativestresstotal knee replacement

Identifiers

PMID42688775
PMCPMC13535071

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