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[哪些问题适合用于预测急性下背痛患者的慢性病风险?]

[What questions are appropriate for predicting the risk of chronic disease in patients suffering from acute low back pain?].

作者信息

Neubauer E, Pirron P, Junge A, Seemann H, Schiltenwolf M

机构信息

Orthopädische Universitätsklinik, Heidelberg.

出版信息

Z Orthop Ihre Grenzgeb. 2005 May-Jun;143(3):299-301. doi: 10.1055/s-2005-836632.

Abstract

AIM

The objective of the study was to develop a brief questionnaire to determine the risk of chronification for patients suffering from lumbar (low) back pain who are consulting a physician for the first or second time.

METHOD

At the outset, and again after six months, a questionnaire with 167 valid items for chronification was distributed to patients in orthopedic offices. After six months, patients were contacted by mail to inquire whether they were still suffering from back pain. Based on outcome (persistence of back pain/absence of back pain) and by means of logistic regression analysis, those variables were determined that could predict actual chronification.

RESULTS

The following items were predictive: "How strong was your back pain during the last week when it was most tolerable?" and "How much residual pain would you be willing to tolerate while still considering the therapy successful?" (Acceptance value, beta = 0.61), patient's educational level (beta = - 0.44), massage is experienced as bringing relief (beta = 0.44), 5 items of the Zung scale for depression (beta = 0.42), items of the scale for catastrophizing thoughts (beta = 0.41) and items of the scale for feelings of helplessness (beta = - 0.39) of the Kiel pain inventory; duration of the back pain for longer than 1 week (beta = 0.38), pain in other parts of the body (beta = 0.37); and female gender (beta = 0.25)

CONCLUSION

Based on these questions, it was possible to predict the chronification of back pain with a probability of 78.05 %. A corresponding questionnaire and an evaluative table were developed.

摘要

目的

本研究的目的是开发一份简短问卷,以确定首次或第二次咨询医生的腰痛患者的慢性化风险。

方法

一开始,以及在六个月后,向骨科诊所的患者发放一份包含167个有效慢性化项目的问卷。六个月后,通过邮件联系患者,询问他们是否仍患有背痛。基于结果(背痛持续/背痛消失)并通过逻辑回归分析,确定那些可以预测实际慢性化的变量。

结果

以下项目具有预测性:“上周您的背痛最能忍受时有多严重?”以及“在仍认为治疗成功的情况下,您愿意忍受多少残余疼痛?”(接受值,β = 0.61),患者的教育水平(β = - 0.44),按摩能缓解疼痛(β = 0.44),Zung抑郁量表的5个项目(β = 0.42),灾难化思维量表的项目(β = 0.41)以及基尔疼痛量表中无助感量表的项目(β = - 0.39);背痛持续时间超过1周(β = 0.38),身体其他部位疼痛(β = 0.37);以及女性(β = 0.25)

结论

基于这些问题,可以以78.05%的概率预测背痛的慢性化。开发了相应的问卷和评估表。

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