Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2025; 15(9): 106196
Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.106196
Correlation between anxiety, depression, sense of coherence, and post-traumatic growth in patients who underwent intertrochanteric femoral fracture surgery
Yuan-Peng Wu, Gui Xu, Zhen Wang
Yuan-Peng Wu, Gui Xu, Zhen Wang, Department of Hand and Foot Surgery, Dongying People’s Hospital, Dongying 257091, Shandong Province, China
Co-first authors: Yuan-Peng Wu and Gui Xu.
Author contributions: Wu YP designed and performed the research; Wu YP and Xu G contributed equally to this article, they are the co-first authors of this manuscript; Wu YP and Wang Z designed the research and supervised the report; Wu YP, Xu G, and Wang Z collected and analyzed data; and all authors approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Dongying People’s Hospital, approval No. 2025-029.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen Wang, Department of Hand and Foot Surgery, Dongying People’s Hospital, No. 317 Dongcheng South Frist Road, Dongying 257091, Shandong Province, China. zkk1869@126.com
Received: April 18, 2025
Revised: May 18, 2025
Accepted: July 11, 2025
Published online: September 19, 2025
Processing time: 130 Days and 1.7 Hours
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: Intertrochanteric femoral fracture; Anxiety; Depression; Sense of coherence; Post-traumatic growth

Core Tip: By conducting a comprehensive analysis of clinical data, this study reveals an inverse correlation between post-traumatic growth levels and anxiety/depression in patients who underwent intertrochanteric femoral fracture surgery, while revealing a positive association with sense of coherence. Notably, patients with higher socioeconomic status (including greater income), absence of comorbidities, and regular exercise habits demonstrated more pronounced post-traumatic growth. These results highlight the importance of routine psychological assessment in clinical practice and indicate that targeted psychological interventions combined with rehabilitation guidance could effectively mitigate negative emotions and optimize overall recovery.