Saunders K W, Von Korff M V, Grothaus L C
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, 98101, USA.
Clin J Pain. 2000 Sep;16(3):236-43. doi: 10.1097/00002508-200009000-00009.
The goal of this study was to explain how primary care back pain patients who volunteer for a group-format self-care intervention differ from nonvolunteers. This is relevant to the generalizability of studies that rely on volunteers as well as the characteristics of patients who do not seek out self-care interventions.
This study was conducted at a large health maintenance organization in western Washington state.
"Volunteers" (n = 481) were primary care back pain patients participating in randomized trials of a self-management intervention who were recruited through passive nonintensive means (a mailed invitation). "Nonvolunteers" (n = 967) consisted of a representative sample of consecutive back pain patients. We compared the baseline characteristics of these two groups.
The relatively small percentage (8%) of primary care back pain patients who volunteered for, and ultimately participated in, group self-management classes tended to be white, older, better educated, and more likely to be retired than nonvolunteers. The two groups did not differ significantly on most clinical measures, including pain intensity and persistence. Patients experiencing the highest (and lowest) levels of pain-related activity interference were less likely to volunteer than those with moderate activity limitations, however.
Those individuals volunteering to participate in a group-format self-care intervention in a primary care setting differed from nonvolunteers primarily on demographic measures as opposed to clinical measures. Back pain patients experiencing the highest levels of activity limitations were somewhat less likely to participate than those with moderate activity limitations. Recruitment for effective self-care interventions is an important issue in determining their impact on a population basis.
本研究的目的是解释自愿参加团体形式自我护理干预的初级保健背痛患者与非自愿参与者有何不同。这与依赖志愿者的研究的普遍性以及不寻求自我护理干预的患者的特征相关。
本研究在华盛顿州西部的一家大型健康维护组织进行。
“志愿者”（n = 481）是通过被动非密集方式（邮寄邀请）招募的参与自我管理干预随机试验的初级保健背痛患者。“非志愿者”（n = 967）由连续背痛患者的代表性样本组成。我们比较了这两组的基线特征。
自愿并最终参加团体自我管理课程的初级保健背痛患者比例相对较小（8%），他们往往比非志愿者更可能是白人、年龄更大、受教育程度更高且更有可能退休。两组在大多数临床指标上没有显著差异，包括疼痛强度和持续时间。然而，与活动受限程度中等的患者相比，经历与疼痛相关的活动干扰程度最高（和最低）的患者更不太可能自愿参与。
在初级保健环境中自愿参加团体形式自我护理干预的个体与非志愿者的主要差异在于人口统计学指标而非临床指标。与活动受限程度中等的患者相比，活动受限程度最高的背痛患者参与的可能性略低。确定有效的自我护理干预措施的招募方式是决定其对总体人群影响的一个重要问题。
