Staal Collette, Arends Amy, Ho Sam
Center for Limb Differences, Mary Free Bed Hospital and Rehabilitation Center, 235 Wealthy Street, Grand Rapids, MI 49503, USA.
Rehabil Nurs. 2003 Sep-Oct;28(5):159-63. doi: 10.1002/j.2048-7940.2003.tb02050.x.
The purpose of this study was to explore through a department quality improvement tool a possible relation between quality of life (QOL), complication rates, and length of intrathecal baclofen (IB) treatment as reported by patients receiving IB therapy in a community-based rehabilitation center outpatient clinic. A second objective was to examine complication rates among the clinic's patients. No conclusions could be drawn as to the relation between QOL, various reported complications, and length of treatment. A rank order frequency of areas reported by respondents to have the greatest impact on their QOL could be extrapolated from the data collected. In addition, complication rates among the patients who responded to the survey could be reported. Surveys from 49 patients about their experiences with IB therapy were analyzed. Respondents included 30 adult and 19 pediatric patients. Thirty-six patients (73%) had used the IB pump for 1 year or more. The survey included questions about QOL, complications, and length of IB treatment. Forty-three respondents (88%) stated they felt that their QOL had improved with IB therapy. Four patients (8%) responded that they were not sure that it had, and only 2 patients (4%) said that IB had not improved their QOL. The most frequently reported positive effects on QOL were reported in the following areas: spasticity control without the sedative effect of oral medication; ease of care for caregivers; easier positioning; less pain/increased comfort; and improved patient transfers. High ratings of improvement in the patients' QOL were reported despite a reported overall complication rate of 39%. The most common complications cited were infection and catheter breakage or disconnect. The overall infection rate for respondents was 10% (5 patients of the 49 surveyed reported infection). The rate of catheter breakage or disconnect was also 10%. Despite the complications reported, 46 patients stated they would recommend baclofen treatment to others. Three patients did not respond to the question. None of the patients said they would not recommend baclofen to others.
本研究的目的是通过一种科室质量改进工具，探讨在社区康复中心门诊接受鞘内注射巴氯芬（IB）治疗的患者所报告的生活质量（QOL）、并发症发生率与鞘内注射巴氯芬治疗时长之间可能存在的关系。第二个目标是检查该诊所患者的并发症发生率。关于生活质量、各种报告的并发症和治疗时长之间的关系，无法得出任何结论。从收集的数据中可以推断出受访者报告的对其生活质量影响最大的领域的排序频率。此外，可以报告对调查做出回应的患者的并发症发生率。分析了49名患者关于他们接受IB治疗经历的调查。受访者包括30名成年患者和19名儿科患者。36名患者（73%）使用IB泵达1年或更长时间。该调查包括关于生活质量、并发症和IB治疗时长的问题。43名受访者（88%）表示他们觉得IB治疗改善了他们的生活质量。4名患者（8%）回答不确定是否改善，只有2名患者（4%）表示IB没有改善他们的生活质量。对生活质量最常报告的积极影响出现在以下方面：控制痉挛且无口服药物的镇静作用；护理人员护理轻松；体位摆放更容易；疼痛减轻/舒适度提高；以及患者转移更容易。尽管报告的总体并发症发生率为39%，但患者生活质量的改善评分较高。最常提到的并发症是感染以及导管断裂或断开。受访者的总体感染率为10%（49名接受调查的患者中有5名报告感染）。导管断裂或断开的发生率也是10%。尽管报告了并发症，但46名患者表示他们会向其他人推荐巴氯芬治疗。3名患者未回答该问题。没有患者表示他们不会向其他人推荐巴氯芬。
