Coccheri S, Gasbarrini G, Valenti M, Nappi G, Di Orio F
Cardiovascular Department, University of Bologna, Italy.
Int J Biometeorol. 2008 Jan;52(3):231-7. doi: 10.1007/s00484-007-0117-4. Epub 2007 Sep 6.
Goal of this study was to investigate whether appropriately applied spa therapy in several indications could be associated with a subsequent fall in the need for costly health services and missed working days due to sick-leave. The Naiade project was a multicenter observational, longitudinal, questionnaire-based study comparing an "entry" inquiry addressed to patients before an entry thermal cycle, and a "return" inquiry after 1 year. Routine statistical methods were used for comparisons. The study was carried out in 297 of the 340 certified Italian spa centers. Inquiries were managed by the spa doctor(s), with the collaboration of family doctors, and when necessary, hospitals, other health services, labour offices and employers. After exclusion of regular customers and of patients with acute disease phases or severe health conditions, 39,943 patients divided into eight diseases subgroups (rheumatic, respiratory, dermatologic, gynaecologic, otorhynologic, urinary, vascular and gastroenteric) underwent entry inquiry and appropriate spa treatment. Patients who returned for treatment after 1 year ("index year") were 23,680 (59.2%) and received return inquiry. Outcomes considered were: frequency and duration of hospitalisation periods; missed working days; regular use of disease-specific drugs; and resort to "non-spa" rehabilitation therapies. The data collected at return inquiry were compared with those of entry inquiry. All the considered outcomes appeared to be significantly reduced in the index year in seven of the eight disease subgroups in comparison with the previous year. In conclusion, disease-appropriate spa treatments were followed by a reduction in the need of subsequent health interventions in most disease subgroups. The health promoting value of spa treatments should therefore undergo more rigorous assessment with randomised controlled studies.
本研究的目的是调查在多种适应症中适当应用水疗疗法是否会导致随后因病假而产生的昂贵医疗服务需求和工作日缺勤的减少。奈亚德项目是一项多中心观察性纵向问卷调查研究，比较了在进入热循环之前向患者进行的“入院”询问和1年后的“回访”询问。使用常规统计方法进行比较。该研究在意大利340家认证水疗中心中的297家进行。询问由水疗医生在家庭医生的协作下进行，必要时还会与医院、其他医疗服务机构、劳动办公室和雇主合作。在排除常客以及处于急性疾病阶段或患有严重健康状况的患者后，39943名患者被分为八个疾病亚组（风湿性、呼吸性、皮肤病性、妇科、耳鼻喉科、泌尿性、血管性和胃肠性），接受了入院询问和适当的水疗治疗。1年后（“索引年”）返回接受治疗的患者有23680名（59.2%），并接受了回访询问。所考虑的结果包括：住院时间的频率和时长；工作日缺勤；特定疾病药物的常规使用；以及求助于“非水疗”康复疗法。将回访询问收集的数据与入院询问的数据进行比较。与上一年相比，在八个疾病亚组中的七个亚组中，索引年中所有考虑的结果似乎都显著减少。总之，在大多数疾病亚组中，针对疾病的水疗治疗之后，后续健康干预的需求有所减少。因此，水疗治疗的健康促进价值应该通过随机对照研究进行更严格的评估。
