Joos Bettina, Uebelhart Daniel, Michel Beat A, Sprott Haiko
Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Switzerland.
J Negat Results Biomed. 2004 Mar 17;3:1. doi: 10.1186/1477-5751-3-1.
Approximately 10 to 20 percent of the population is suffering from chronic pain. Since this represents a major contribution to the costs of the health care system, more efficient measures and interventions to treat these patients are sought.
The development of general health and physical activity of patients with chronic pain was assessed in an interdisciplinary outpatient pain management program (IOPP). 36 patients with an average age of 48 years were included in the IOPP. Subjective assessment of well-being was performed at five time points (baseline, post intervention and 3, 6, and 12 months thereafter) by using standardized questionnaires. The study focused on the quality of life survey Medical Outcomes Study Short Form-36, which is a validated instrument with established reliability and sensitivity. In addition, the patients participated in physical assessment testing strength, power, endurance, and mobility. Prior to therapy a substantial impairment was found on different levels. Marked improvements in the psychological parameters were obtained by the end of the program. No success was achieved with regard to the physical assessments.
Although many different studies have evaluated similar programs, only few of them have attained positive results such as improvements of general quality of life or of physical strength. Often no difference from the control group could be detected only some months after the intervention. In the present study no significant persistent improvement of well-being occurred. Possible reasons are either wrong instruments, wrong selection of patients or wrong interventions.
大约10%至20%的人口患有慢性疼痛。由于这对医疗保健系统的成本有重大影响,因此需要寻求更有效的措施和干预方法来治疗这些患者。
在一个跨学科门诊疼痛管理项目(IOPP)中评估了慢性疼痛患者的总体健康和身体活动情况。36名平均年龄为48岁的患者被纳入IOPP。在五个时间点(基线、干预后以及此后的3个月、6个月和12个月)使用标准化问卷对幸福感进行主观评估。该研究重点关注生活质量调查《医学结果研究简表-36》,这是一种经过验证且具有既定信度和敏感度的工具。此外,患者还参与了测试力量、功率、耐力和活动能力的身体评估。在治疗前发现不同层面存在严重损伤。到项目结束时,心理参数有显著改善。身体评估方面未取得成功。
尽管许多不同的研究评估了类似项目,但只有少数研究取得了积极成果,如总体生活质量或体力的改善。通常在干预仅几个月后,与对照组相比没有发现差异。在本研究中,幸福感没有出现显著的持续改善。可能的原因要么是工具错误、患者选择错误,要么是干预措施错误。