Psychological Factors and Clinical Outcomes after Total Knee Arthroplasty surgery in Patients

Abstract

Abstract Background This study explored insomnia's influence on mental health, general health, and quality of life among total knee arthroplasty (TKA) patients in Northern Iran. It hypothesized that insomnia moderates the link between general and mental health while mediating the connection between general health and quality of life. Methods A cross-sectional survey involved 270 patients who completed depression, mental health, quality of life, and insomnia assessments at one week, one month, and three months post-surgery. Structural equation modelling (SEM) was used to analyse the data. Results The study included 270 patients. General health positively correlated with mental health (0.21, p < 0.01;0.25, p < 0.01; 0.27, p < 0.001). Whereas general health has shown significant relationship with quality of life in time wave 2 and time wave 3(0.13, p < 0.001;0.17, p < 0.01). Mental health also positively influences the quality of life (0.17, p < 0.01; 0.19, p < 0.001;0.22, p < 0.001). Insomnia negatively moderated the relationship between general health and mental health. Furthermore, insomnia mediated the relationship between general health and quality of life in the later time points. The study highlighted the intricate relationships between general health, mental health, quality of life, and insomnia in TKA patients. General health contributed to improved mental health and quality of life over time. Insomnia acted as both a moderator and mediator, affecting these relationships. Conclusion This study sheds light on the complex dynamics affecting TKA outcomes, offering insights for healthcare providers to deliver more comprehensive care for improved patient well-being.