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颈部疼痛患者的临床、心理和个体因素与功能状态的关系。

Relationships of clinical, psychologic, and individual factors with the functional status of neck pain patients.

作者信息

Luo Xuemei, Edwards Christopher L, Richardson William, Hey Lloyd

机构信息

Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.

出版信息

Value Health. 2004 Jan-Feb;7(1):61-9. doi: 10.1111/j.1524-4733.2004.71264.x.

Abstract

OBJECTIVE

The objective of this study was to use both generic and disease-specific functional measures examining relationships of clinical, psychologic, and individual factors with the functional status of neck pain patients.

METHODS

Patients who visited a university-based spine clinic and reported neck pain were included in this study. A comprehensive computerized survey questionnaire was used to collect the information related to this study. The questionnaire also contained a generic measure, short form 12-item survey (SF-12), and a disease-specific measure, neck disability index (NDI). Correlation and multiple regression analysis were conducted to examine the relationships.

RESULTS

A range of clinical, psychologic, and individual factors emerged to be significant predictors of the NDI or physical component of the SF-12 (PCS). The predictors of higher NDI included higher levels of neck pain, higher levels of back pain, higher levels of pain in arm or shoulder areas, not working, lower education, higher stress, the presence of depression or anxiety, and smoking. The predictors of lower PCS included not working, higher levels of back pain, higher levels of neck pain, lower education, female sex, the presence of cardiovascular disorders, the absence of cervical disk disorders, and older age.

CONCLUSIONS

The predictors of the NDI or PCS appear to be multidimensional. Interventions designed to maximally improve the functional status of neck pain patients should be multifaceted and involve multidisciplinary teams. Selection of the most appropriate functional measures for an intervention study should consider differences between the generic and disease-specific measures in terms of their respective relationships with targeted factors. Prospective studies are needed to confirm the relationships observed in this study.

摘要

目的

本研究的目的是使用通用和疾病特异性功能测量方法,研究临床、心理和个体因素与颈部疼痛患者功能状态之间的关系。

方法

本研究纳入了前往大学脊柱诊所就诊并报告有颈部疼痛的患者。使用综合计算机调查问卷收集与本研究相关的信息。该问卷还包含一项通用测量方法,即简短形式12项调查问卷(SF-12),以及一项疾病特异性测量方法,即颈部残疾指数(NDI)。进行相关性和多元回归分析以研究这些关系。

结果

一系列临床、心理和个体因素成为NDI或SF-12身体成分(PCS)的重要预测因素。NDI较高的预测因素包括颈部疼痛程度较高、背部疼痛程度较高、手臂或肩部疼痛程度较高、未工作、教育程度较低、压力较高、存在抑郁或焦虑以及吸烟。PCS较低的预测因素包括未工作、背部疼痛程度较高、颈部疼痛程度较高、教育程度较低、女性、存在心血管疾病、不存在颈椎间盘疾病以及年龄较大。

结论

NDI或PCS的预测因素似乎是多维度的。旨在最大程度改善颈部疼痛患者功能状态的干预措施应是多方面的,并涉及多学科团队。在干预研究中选择最合适的功能测量方法时,应考虑通用测量方法和疾病特异性测量方法在与目标因素各自关系方面的差异。需要进行前瞻性研究以证实本研究中观察到的关系。

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