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Item Examining the role of mental health in determining the quality of life after total knee arthroplasty surgery: a multi-wave study(Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological, 2025-04-24) Khalilzad, Majid; Lathabhavan, Remya; Marznaki, Zohreh Hosseini; Nukpezah, Ruth Nimota; Mudgal, Shiv Kumar; Afshar, Amir MahmoudThe study examines the relationships of general health, mental health and quality of life among individuals in Northern Iran following total knee arthroplasty (TKA). It also explores the effect of post-surgical insomnia on mental health and general health among the TKA patients. A longitudinal survey was conducted using self-reported data from 270 patients who were assessed for depression, mental health, quality of life, and insomnia at one week (T1), one month (T2), and three months (T3) post-surgery. Structural equation modelling (SEM) was used to analyse the data. The study revealed that general health was positively related to mental health over time (0.21, p<0.01; 0.25, p<0.01; 0.27, p<0.001). General health showed significant relationship with quality of life during the second time period (one month) 3(0.13, p<0.001; 0.17, p<0.01). Mental health was also seen to positively influence 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, mental health mediated the relationship between general health and quality of life during T2 and T3. The study underscores the intricate interplay between general health, mental health, and quality of life, with insomnia as a moderating factor in TKA patients. General health contributed to improved mental health and quality of life over time. This study sheds light on the complex factors influencing TKA outcomes, providing valuable insights for healthcare providers to enhance patient care and overall well-being.