在《国际功能、残疾和健康分类》腰痛核心集中保留患者视角。
Retaining the patient perspective in the International Classification of Functioning, Disability and Health Core Set for low back pain.
作者信息
Røe Cecilie, Sveen Unni, Bautz-Holter Erik
机构信息
Department of Physical Medicine and Rehabilitation, Ulleval University Hospital, Oslo, Norway;
出版信息
Patient Prefer Adherence. 2008 Feb 2;2:337-47. doi: 10.2147/ppa.s4419.
OBJECTIVE
To examine the relationship between health problems as rated by the health professionals in the Norwegian form of the Core Set for low back pain and the patients' self-reported health problems in Oswestry Disability Index (ODI) and World Health Organization Disability Assessment Schedule II (WHODAS II).
METHODS
This was part of an international multicenter study where a convenience sample of 118 Norwegian patients with low back pain (LBP) participated. The ICF Core Set for LBP was filled in by the health professionals. The patients reported their health problems in the WHODAS II and ODI. The items in WHODAS II and ODI were linked to the ICF. The problems reported in WHODAS II and ODI were compared to the problems scored by the health professionals in the linked ICF categories in the Comprehensive ICF Core Set for LBP.
RESULTS
All items in ODI could be linked the ICF. Four items in WHODAS II could not be linked to the ICF and additionally two items could not be linked to specific ICF categories. All ICF categories linked to the ODI were included in the Comprehensive Core Set for LBP, whereas six items in WHODAS II could not be linked, and additionally 11 of the items were not represented in the Core Set. With the exception of sexual function, above three quarter of the patients' reported problems within body functions was captured by the health professionals. Within several of the activities and participation categories the health professionals scores in the ICF reflected the patients' reported problems well. Surprisingly some of the problems in activities of daily living were poorly reflected.
CONCLUSION
The Comprehensive ICF Core Set for LBP covers most of the items in ODI and WHODAS II in areas where patients report significant problems, with some exceptions. The subjective dimension related to the impact of the health condition as well as the feeling of being a burden to their family appeared to be important to these patients and not covered in the ICF. Problems with sexual functions and relationship were poorly reflected in the health professionals' scores in the Comprehensive ICF Core Set for LBP. In clinical practice it is a challenge to assess the individual patients' broad spectrum of problems precisely.
目的
探讨挪威版腰痛核心集量表中卫生专业人员评定的健康问题与患者在奥斯威斯残疾指数（ODI）和世界卫生组织残疾评定量表第二版（WHODAS II）中自我报告的健康问题之间的关系。
方法
这是一项国际多中心研究的一部分，118名挪威腰痛患者的便利样本参与其中。卫生专业人员填写腰痛的国际功能、残疾和健康分类（ICF）核心集量表。患者在WHODAS II和ODI中报告他们的健康问题。WHODAS II和ODI中的条目与ICF相关联。将WHODAS II和ODI中报告的问题与卫生专业人员在腰痛综合ICF核心集中相关ICF类别中评分的问题进行比较。
结果
ODI中的所有条目都可以与ICF相关联。WHODAS II中的四个条目无法与ICF相关联，另外两个条目无法与特定的ICF类别相关联。与ODI相关联的所有ICF类别都包含在腰痛综合核心集中，而WHODAS II中有六个条目无法关联，另外11个条目在核心集中未体现。除性功能外，卫生专业人员捕捉到了超过四分之三患者报告的身体功能方面问题。在几个活动和参与类别中，卫生专业人员在ICF中的评分很好地反映了患者报告的问题。令人惊讶的是，日常生活活动中的一些问题反映不佳。
结论
腰痛综合ICF核心集涵盖了ODI和WHODAS II中患者报告有重大问题领域的大多数条目，但有一些例外。与健康状况影响相关的主观维度以及成为家庭负担的感受对这些患者似乎很重要，而ICF中未涵盖。性功能和人际关系方面的问题在腰痛综合ICF核心集中卫生专业人员的评分中反映不佳。在临床实践中，准确评估个体患者广泛的问题是一项挑战。
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