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World J Psychiatry. Oct 19, 2026; 16(10): 119507
Published online Oct 19, 2026. doi: 10.5498/wjp.119507
Trajectories of anxiety and depression levels in older adult patients undergoing total hip arthroplasty
Xiao-Yu Wang, Wei-Hua Zheng, Yan-Yun Niu, Can Chen, Yong-Min Wang, Rui Li, Yong-Hui Dong
Xiao-Yu Wang, Wei-Hua Zheng, Yan-Yun Niu, Can Chen, Department of Orthopedics, Henan Provincial People’s Hospital, Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Yong-Min Wang, Rui Li, Department of Psychological Medicine, Henan Provincial People’s Hospital, Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Yong-Hui Dong, Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Author contributions: Wang XY conceived the study concept, developed the methodology, conducted the investigation, performed data curation, and drafted the original manuscript; Dong YH, Wang YM, and Li R designed the overall research framework and supervised the study; Zheng WH, Niu YY, and Chen C collected the clinical data, participated in manuscript revision and proofreading, and verified the methodological feasibility.
AI contribution statement: No AI tool used for language polishing, translation, data analysis, or writing assistance of the main text and the response to reviewers.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Henan Provincial People’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Yong-Hui Dong, Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, No. 7 Weiwu Road, Zhengzhou 450003, Henan Province, China.
yonghuidong50343@163.com
Received: March 27, 2026
Revised: May 6, 2026
Accepted: June 3, 2026
Published online: October 19, 2026
Processing time: 197 Days and 0.2 Hours
BACKGROUND
Total hip arthroplasty (THA) has become a core means of joint function enhancement among older adult patients due to global population aging. However, postoperative anxiety and depression compromise patients’ rehabilitation and quality of life.
AIM
To explore anxiety/depression trajectories among older adults who have undergone THA, identify high-risk factors, and propose stratified precision nursing strategies.
METHODS
This observational study enrolled 208 older adult patients who had undergone their first unilateral THA between June 2023 and June 2025. The Hamilton Anxiety Rating Scale and Hamilton Rating Scale for Depression-17 items assessed anxiety and depression, respectively, combined with the Visual Analog Scale (VAS), General Self-Efficacy Scale (GSES), and Social Support Rating Scale (SSRS). A latent category growth model was used to identify anxiety/depression subgroups, and multiple logistic regression was used to analyze the independent influencing factors.
RESULTS
Based on the dynamic trajectory of the patients’ anxiety and depression levels, which exhibited a “peaking at 1-week post-operation—gradual relief over the next 1 month”, patients were divided into two subgroups: The stable (42.79%; mild preoperative abnormalities and postoperative recovery after short-term fluctuations) and unstable group (57.21%; patient had moderate-to-severe negative emotions before surgery, which were relieved within three months). Old age (OR = 1.493), low education level (OR = 3.440), 1-week postoperative VAS (OR = 1.916), SSRS (OR = 0.894), and GSES (OR = 0.912) were independent factors for the high-risk group.
CONCLUSION
This study reveals the anxiety/depression heterogeneity among older adults who have undergone THA and suggests that the 1-week to 1-month post-operation is the key psychological intervention window.
Core Tip: This study explored the anxiety/depression trajectories in older adult patients who have undergone total hip arthroplasty via a latent category growth model and identified two subgroups. Postoperative 1-week to 1-month is the key intervention window. Old age, low education level, and postoperative pain are risk factors, while social support and self-efficacy are protective factors. These results provide a basis for precise stratified nursing.
