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A prospective cohort study recruiting participants from the Shouldice Hospital. The study population consists of healthy patients electing to receive hernia surgery for a primary inguinal hernia on an inpatient basis. The goal of this study is to determine the incidence of hernia pain and its intensity as well as other related outcomes up to one year after primary unilateral inguinal hernia repair.
Proportion of participants with pain severity scores > zero at one year [ Time Frame: one-year post surgery ]
Brief Pain Inventory - pain severity 0-10 numeric rating scale. Typically score >= 4 corresponds to moderate-to severe pain severity
Proportion of participants with pain-related interference in multiple life domains [ Time Frame: one-year post surgery ]
Brief Pain Inventory - pain interference
Proportion of participants with neuropathic pain symptoms [ Time Frame: one year ]
ID Pain 6-items total score ranges from 0 to 6
Secondary Outcome Measures :
proportion of participants with significant symptoms of anxiety, depression [ Time Frame: one-year post surgery ]
Patient Health Questionnaire for Depression and Anxiety - PHQ-4 total score range from 0-12; anxiety subscale 0-6; depression subscale 0-6. total score cutoffs: 0-2 normal; 3-5 mild; 6-8 moderate; 9-12 severe
Do preoperative perceived stress scores predict pain incidence, severity, and/or interference [ Time Frame: one-year ]
Stress Assessment Test - no norms at present. Scale developed by authors and being validated.
Does pre-operative resilience scores predict lower pain incidence, severity, and/or interference [ Time Frame: one-year ]
Connor-Davidson Resilience Scale-2. Total score ranges from 0-8. There are no clinical cut-offs for this scale
Do pain preoperative and early postoperative pain catastrophizing scores predict pain incidence, severity, and/or interference [ Time Frame: one year ]
Pain Catastrophizing Scale -4 item. Total score range: 0-16. There are no sub scales and no cut-offs for this scale
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Layout table for eligibility information
Ages Eligible for Study:
18 Years to 90 Years (Adult, Older Adult)
Sexes Eligible for Study:
The population under study comprises patients recruited from Shouldice Hospital undergoing inguinal hernia repair. We aim to recruit a sample size of 3,000 patients, males and females, ages 18-90 years, all nationalities and races, capable of speaking and reading English, in good general health, there is no geographic location constraint.
Provide signed and dated informed consent form.
Willing to comply with all study procedures and be available for the duration of the study (patients have fixed address, access to phone, email, internet, and/or a computer)
Male or female, aged 18 to 90 years.
Subjects having surgery on a primary unilateral inguinal hernia
In good general health as evidenced by medical history
Capable of speaking and reading English sufficiently well to complete the questionnaires
Surgery is deemed an emergency procedure (any obstruction, incarceration or irreducible hernias).
Other abdominal hernias being operated on at the same time or surgery is planned during the follow-up period (incisional and umbilical hernias)
If hernia recurs within the study period and there is a reoperation within the year
Patients unable to understand English, written and spoken
Patients with collagen or connective tissue disorders
Local (site of surgery) or systemic infection
Any known diseases that impair nerve function
Patients who end up getting a mesh repair during surgery
Impairment of cognitive function (e.g. dementia)
Pregnancy or lactation
Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.