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工作相关上肢疾病的二级预防:安纳波利斯会议的建议

Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

作者信息

Feuerstein Michael, Harrington Cherise B

机构信息

Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.

出版信息

J Occup Rehabil. 2006 Sep;16(3):401-9. doi: 10.1007/s10926-006-9030-7.

Abstract

INTRODUCTION

Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge.

METHODS

A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions.

RESULTS

The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal.

CONCLUSIONS

This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help translate this knowledge into effective secondary prevention efforts.

摘要

引言

改善与工作相关的上肢(WRUE)症状的二级预防工作仍然面临挑战。与许多职业性肌肉骨骼疼痛疾病一样,在特定暴露、病理过程和症状之间不存在单一的直接因果关系。该领域尚未基于当前的流行病学和临床知识,为这些问题创建真正有效且高效的干预措施。

方法

2005年9月23日和24日,在马里兰州安纳波利斯召开了一次工作会议,参会人员为上肢疾病研究及应用领域的领导者,以应对这一挑战。会议的目的是回顾流行病学和干预研究方面的“前沿”证据,以便就干预研究及应用的后续步骤提出建议。在第二天,众多利益相关者出席会议,讨论他们认为在流行病学研究和应用干预研究中所缺失的环节,从而制定出更有效的工作场所干预措施。

结果

《职业康复杂志》这一系列论文表明,在过去十年中,在确定这些症状/疾病的病因及病情加重过程中的人体工程学、工作场所心理社会因素和个体因素方面,已经取得了合理的科学进展。然而,这些知识与针对这些问题的综合干预措施的开发和实际实施之间仍存在差距。会议还强调了对这些疾病影响的经济分析以及干预影响的经济研究的匮乏。本文介绍了此类评估方法,并将其纳入该期刊的这一特刊。

结论

这一系列论文以及本文中受邀小组讨论的总结明确强调,需要创新思维方式来思考这些问题,并开展特定的研究课题,以帮助将这些知识转化为有效的二级预防措施。

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