Sanchez Katherine, Papelard Agathe, Nguyen Christelle, Jousse Marylène, Rannou François, Revel Michel, Poiraudeau Serge
AP-HP Service de Médecine Physique et Réadaptation, Hôpital Cochin, Institut Federatif de Recherche sur le Handicap (IFR 25), Université Paris Descartes, INSERM, Paris, France.
Spine (Phila Pa 1976). 2009 May 1;34(10):1052-9. doi: 10.1097/BRS.0b013e31819c093b.
STUDY DESIGN: A cross sectional survey. OBJECTIVE.: To assess patient priorities in disability and restriction in participation with disabling chronic low back pain (CLBP) by use of the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) and to compare this questionnaire with other outcome measures widely used in this situation. SUMMARY OF BACKGROUND DATA: Disability and participation restriction are widely assessed in CLBP but do not account for patient priorities. Knowing what is important to patients could be useful to help form treatment goals and plans. METHODS: A total of 150 patients hospitalized in a tertiary care teaching hospital for the management of CLBP were enrolled in the study. Evaluation was by the MACTAR, the Quebec Back Pain Disability Questionnaire (QUEBEC), the Hospital Anxiety and Depression scale, the Fear-Avoidance Beliefs Questionnaire, the Coping Strategies Questionnaire, and pain and handicap visual analog scales. Correlations between the MACTAR score and scores for other scales were analyzed by the Spearman coefficient. RESULTS: On the MACTAR, patients with CLBP cited as most important 3 disability domains classified by the International Classification of Functioning, Disability, and Health: mobility (n = 23 activities, 165 times, 33% of the patients); community, social, and civic life (n = 7 activities, 138 times, 27.6% of the patients); and domestic life (n = 10 activities, 123 times, 24.6% of the patients). Patients ranked first in importance 37 different activities, especially sport (n = 29 times; 19.3% of the patients), shopping (n = 14; 9.3% of the patients), and walking (n = 13; 8.7% of the patients). The MACTAR score was correlated moderately with visual analog scale handicap (r = 0.51), weakly with the QUEBEC score (r = 0.40), and not at all with Hospital Anxiety and Depression scale, Fear-Avoidance Beliefs Questionnaire, and Coping Strategies Questionnaire scores. CONCLUSION: For assessing priorities in disability and participation restriction among patients with CLBP, the MACTAR has acceptable construct validity. The weak correlation between QUEBEC and MACTAR scores suggests that the latter scale adds useful information for assessing the health priorities of disabled CLBP patients.
研究设计：横断面调查。目的：使用麦克马斯特 - 多伦多关节炎患者偏好残疾问卷（MACTAR）评估慢性下腰痛（CLBP）患者在残疾和参与受限方面的优先事项，并将该问卷与这种情况下广泛使用的其他结局指标进行比较。 背景数据总结：在CLBP中广泛评估残疾和参与受限情况，但未考虑患者的优先事项。了解对患者重要的事项可能有助于制定治疗目标和计划。 方法：共有150名在三级护理教学医院因CLBP治疗而住院的患者纳入研究。通过MACTAR、魁北克背痛残疾问卷（QUEBEC）、医院焦虑和抑郁量表、恐惧 - 回避信念问卷、应对策略问卷以及疼痛和残疾视觉模拟量表进行评估。通过斯皮尔曼系数分析MACTAR评分与其他量表评分之间的相关性。 结果：在MACTAR上，CLBP患者将国际功能、残疾和健康分类中列出的3个残疾领域列为最重要：活动能力（n = 23项活动，165次提及，占患者的33%）；社区、社会和公民生活（n = 7项活动，138次提及，占患者的27.6%）；以及家庭生活（n = 10项活动，123次提及，占患者的24.6%）。患者将37项不同活动列为最重要，尤其是运动（n = 29次提及；占患者的19.3%）、购物（n = 14次提及；占患者的9.3%）和步行（n = 13次提及；占患者的8.7%）。MACTAR评分与视觉模拟量表残疾评分中度相关（r = 0.51），与QUEBEC评分弱相关（r = 0.40），与医院焦虑和抑郁量表、恐惧 - 回避信念问卷以及应对策略问卷评分完全不相关。 结论：对于评估CLBP患者在残疾和参与受限方面的优先事项，MACTAR具有可接受的结构效度。QUEBEC和MACTAR评分之间的弱相关性表明，后一种量表为评估残疾CLBP患者的健康优先事项增添了有用信息。
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