Bachrach-Lindström Margareta, Karlsson Susanne, Pettersson Lars-Göran, Johansson Torsten
Division of Nursing Science, Department of Medicine and Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
Scand J Caring Sci. 2008 Dec;22(4):536-42. doi: 10.1111/j.1471-6712.2007.00567.x.
Untreated osteoarthritis (OA) in the hip causes pain and reduced physical and social functioning. The aim of this study was to evaluate the effect of waiting time on health-related quality of life (HRQOL), functional condition and dependence on help at the time of surgery and during follow-up 1 year after surgery. A further aim was to elucidate possible differences between men and women. Two hundred and twenty-nine consecutively included patients with OA in the hip were interviewed when assigned to the waiting list, again 1 week prior to surgery with unilateral total hip replacement (THR), and 1 year after surgery. Health-related quality of life and function were measured using the Nottingham Health Profile, EuroQoL and the Western Ontario and McMaster Universities Osteoarthritis Index. The result showed that the average waiting time was 239 days, that 15% of the patients were operated on within 3 months, and that 21% had to wait more than 6 months. At the time of surgery, HRQOL had deteriorated significantly (p < 0.05) and the number of patients receiving support from relatives had increased from 31% to 58% during the wait. At the 1-year follow-up, both HRQOL and functional condition had improved significantly despite the wait, and the need for support from relatives had decreased to 11% (p < 0.001). In conclusion, long waiting time for THR is detrimental to patients' HRQOL causing reduced functional condition, pain and increased need for support from relatives, which limit the independence in daily life.
未治疗的髋关节骨关节炎(OA)会导致疼痛,并降低身体和社交功能。本研究的目的是评估等待时间对健康相关生活质量(HRQOL)、功能状况以及手术时和术后1年随访期间对帮助的依赖程度的影响。另一个目的是阐明男性和女性之间可能存在的差异。对229例连续纳入的髋关节OA患者在被列入等待名单时、单侧全髋关节置换术(THR)手术前1周以及术后1年进行了访谈。使用诺丁汉健康量表、欧洲五维度健康量表和西安大略和麦克马斯特大学骨关节炎指数来测量健康相关生活质量和功能。结果显示,平均等待时间为239天,15%的患者在3个月内接受了手术,21%的患者不得不等待超过6个月。在手术时,HRQOL显著恶化(p < 0.05),在等待期间接受亲属支持的患者数量从31%增加到了58%。在1年随访时,尽管有等待期,但HRQOL和功能状况均有显著改善,对亲属支持的需求降至11%(p < 0.001)。总之,THR的长时间等待对患者的HRQOL有害,会导致功能状况下降、疼痛以及对亲属支持的需求增加,从而限制了日常生活中的独立性。