Bedson John, Mottram Sara, Thomas Elaine, Peat George
Primary Care Musculoskeletal Research Centre, Keele University, Newcastle-under-Lyme, Staffordshire, UK.
Fam Pract. 2007 Oct;24(5):443-53. doi: 10.1093/fampra/cmm036. Epub 2007 Aug 4.
We examined the relationship between predisposing factors, enabling factors and need-related factors with consultation for knee pain in general practice.
This was a retrospective review of computerized medical records for knee-related consultations in the 18 months before baseline assessment of individuals aged over 50 years reporting knee pain in the previous 12 months. The association between each factor and consultation for consulters compared to non-consulters was summarized using odds ratios (ORs). Interaction between each variable and chronic pain grade was investigated. The association between knee-related consultation and the number and type of other co-morbid consultations was then determined.
In total, 742 participants were assessed. Of these, 209 (28%) had a knee-related consultation in the previous 18 months. Recent onset of pain [OR 3.2; 95% confidence interval (95% CI) 1.8, 5.7] and severity of pain, Grade III/IV (OR 3.4; 95% CI 2.1, 5.6), were associated with knee-related consultation. Those rating their knee problem as a health priority were more likely to consult (OR 3.2; 95% CI 1.6, 6.7). Irrespective of knee pain severity, there was no difference in the median number of co-morbid consultations between knee consulters and knee non-consulters.
Need-related factors appeared to be associated with the decision to consult about knee pain. Neither the presence of self-reported selected co-morbid conditions nor the total number of co-morbid conditions was related to consultations for knee pain. Nevertheless, 50% of those with severely disabling knee pain still did not consult for it. Further investigation of this is important in order to optimize care for patients with knee pain and co-morbid disease.
我们研究了一般医疗实践中膝关节疼痛咨询的诱发因素、促成因素和需求相关因素之间的关系。
这是一项对50岁以上、在过去12个月中报告有膝关节疼痛的个体进行基线评估前18个月内膝关节相关咨询的计算机化病历回顾性研究。使用比值比（OR）总结每个因素与咨询者（与未咨询者相比）咨询之间的关联。研究每个变量与慢性疼痛分级之间的相互作用。然后确定膝关节相关咨询与其他合并症咨询的数量和类型之间的关联。
总共评估了742名参与者。其中，209名（28%）在过去18个月内进行了膝关节相关咨询。近期疼痛发作[OR 3.2；95%置信区间（95%CI）1.8，5.7]和疼痛严重程度（III/IV级，OR 3.4；95%CI 2.1，5.6）与膝关节相关咨询有关。将膝关节问题视为健康优先事项的人更有可能咨询（OR 3.2；95%CI 1.6，6.7）。无论膝关节疼痛严重程度如何，膝关节咨询者和非咨询者之间合并症咨询的中位数数量没有差异。
需求相关因素似乎与膝关节疼痛咨询的决定有关。自我报告的选定合并症的存在或合并症的总数均与膝关节疼痛咨询无关。然而，50%的膝关节疼痛严重致残者仍未就此咨询。对此进行进一步调查对于优化膝关节疼痛和合并症患者的护理很重要。
