Jinks C, Jordan K, Ong B N, Croft P
Primary Care Sciences Research Centre, Keele University, UK.
Rheumatology (Oxford). 2004 Jan;43(1):55-61. doi: 10.1093/rheumatology/keg438. Epub 2003 Aug 15.
To use a brief screening tool to identify knee pain (all knee pain, non-chronic and chronic knee pain) and associated health-care use in the general population aged 50 yr and over.
A cross-sectional survey was mailed to 8995 individuals registered with three general practices in North Staffordshire, UK. The questionnaire included a Knee Pain Screening Tool (KNEST), the Short Form 36 (SF36), demographic questions and, for those who reported knee pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
The survey achieved a 77% response. The 12-month period prevalence of all knee pain was 46.8% [95% confidence interval (CI) 45.6%, 48.0%]. Figures for non-chronic knee pain (pain of less than 3 months duration) and chronic knee pain (pain of more than 3 months duration) were 21.5% (95% CI 20.5%, 22.5%) and 25.3% (95% CI 24.3%, 26.4%) respectively. An estimated 6% of the older population had non-chronic but severe knee pain or disability. Thirty-three per cent of all knee pain sufferers had consulted their general practitioner (GP) about their symptom in the last year. This included 34% of those with non-chronic but severe knee pain or disability and 56% of those with chronic and severe knee pain or disability. The use of private treatments or services for knee pain was minimal. A third of those with chronic and severe knee pain or disability had not used any services (including GP) in the last year.
The KNEST is a simple tool for the identification of individuals with knee pain and their health-care use. Focusing only on chronic knee pain will underestimate the total need and demand for health-care in knee pain sufferers in the general older population, as non-chronic as well as chronic knee pain has a significant impact on people's lives and on their use of primary health-care. The KNEST, when combined with the WOMAC, identifies population groups who have potentially diverse health-care needs and who might benefit from effective health-care. These data can be used alongside evidence on effective treatments by service planners when considering needs for the care of older adults in primary care.
使用一种简短的筛查工具来识别50岁及以上普通人群中的膝关节疼痛(所有膝关节疼痛、非慢性和慢性膝关节疼痛)以及相关的医疗保健使用情况。
对在英国北斯塔福德郡的三家普通诊所登记的8995名个体进行了横断面调查。问卷包括膝关节疼痛筛查工具(KNEST)、简短健康调查问卷(SF36)、人口统计学问题,对于报告有膝关节疼痛的人,还包括西安大略和麦克马斯特大学骨关节炎指数(WOMAC)。
调查的回应率为77%。所有膝关节疼痛的12个月期间患病率为46.8%[95%置信区间(CI)45.6%,48.0%]。非慢性膝关节疼痛(持续时间少于3个月的疼痛)和慢性膝关节疼痛(持续时间超过3个月的疼痛)的患病率分别为21.5%(95%CI 20.5%,22.5%)和25.3%(95%CI 24.3%,26.4%)。估计6%的老年人群患有非慢性但严重膝关节疼痛或残疾。所有膝关节疼痛患者中有33%在过去一年就其症状咨询过全科医生(GP)。这包括34%患有非慢性但严重膝关节疼痛或残疾的患者以及56%患有慢性且严重膝关节疼痛或残疾的患者。用于膝关节疼痛的私人治疗或服务的使用极少。三分之一患有慢性且严重膝关节疼痛或残疾的患者在过去一年未使用任何服务(包括全科医生服务)。
KNEST是一种用于识别膝关节疼痛个体及其医疗保健使用情况的简单工具。仅关注慢性膝关节疼痛会低估普通老年人群中膝关节疼痛患者对医疗保健的总体需求,因为非慢性以及慢性膝关节疼痛都会对人们的生活及其对初级医疗保健的使用产生重大影响。当KNEST与WOMAC结合使用时,可识别出可能有不同医疗保健需求且可能从有效医疗保健中受益的人群组。在考虑初级保健中老年人护理需求时,这些数据可与有效治疗的证据一起供服务规划者使用。