Shands Healthcare and the University of Florida Orthopedic and Sports Medicine Institute, Gainesville, FL, USA.
Arch Phys Med Rehabil. 2012 Mar;93(3):434-40. doi: 10.1016/j.apmr.2011.10.007. Epub 2012 Jan 24.
(1) To investigate patient-defined parameters of treatment success in an outpatient physical therapy setting with musculoskeletal pain, (2) to determine whether patient-defined treatment success was influenced by selected demographic and clinical factors, and (3) to examine whether patient subgroups existed for ratings of importance for each treatment outcome domain.
Cross-sectional study.
Outpatient physical therapy clinic.
Consecutive patients (N=110) with complaints of musculoskeletal pain.
Not applicable.
We reported patient-defined treatment success targets for pain, fatigue, emotional distress, and interference with daily activities using the Patient-Centered Outcomes Questionnaire (PCOQ). We also investigated whether patient subgroups existed based on perceived importance of improvement for these same outcome domains.
Patient-defined criteria for treatment success included mean reductions (from baseline scores) in pain of 3.0 points, in fatigue of 2.3 points, in emotional distress of 1.4 points, and in interference with daily activities of 3.4 points. There were no differences in patient-defined criteria for treatment success based on sex, age, postoperative rehabilitation, prior physical therapy, other prior health care interventions, duration of symptoms, and anatomical location of symptoms (P>.01). Cluster analysis of the PCOQ importance ratings indicated a 2-cluster solution. The multifocused subgroup demonstrated higher importance for improvement ratings in each treatment outcome domain when compared with the pain-focused subgroup (P>.05).
These data indicate that patient-defined criteria for treatment success required greater reductions in the studied outcome domains to be considered successful. These data suggest the potential existence of patient subgroups that either rate improvement in all outcome domains as important or rate pain relief as the most important outcome.
(1) 调查门诊物理治疗中肌肉骨骼疼痛患者对治疗成功的定义参数；(2) 确定患者定义的治疗成功是否受选定的人口统计学和临床因素影响；(3) 检查是否存在患者亚组，用于评估每个治疗结果领域的重要性。
横断面研究。
门诊物理治疗诊所。
连续就诊的肌肉骨骼疼痛患者（N=110）。
不适用。
我们使用患者为中心的结局问卷（PCOQ）报告患者定义的治疗成功目标，包括疼痛、疲劳、情绪困扰和日常生活活动干扰。我们还调查了是否存在基于对这些相同结果领域改善的感知重要性的患者亚组。
患者定义的治疗成功标准包括疼痛平均降低（与基线分数相比）3.0 分、疲劳降低 2.3 分、情绪困扰降低 1.4 分和日常生活活动干扰降低 3.4 分。患者定义的治疗成功标准在性别、年龄、术后康复、以前的物理治疗、其他以前的医疗保健干预、症状持续时间和症状解剖位置方面没有差异（P>.01）。PCOQ 重要性评分的聚类分析表明存在 2 个聚类解决方案。与疼痛聚焦亚组相比，多焦点亚组在每个治疗结果领域的改善评分中表现出更高的重要性（P>.05）。
这些数据表明，患者定义的治疗成功标准需要在研究结果领域中取得更大的降低，才能被视为成功。这些数据表明，可能存在患者亚组，要么认为所有结果领域的改善都很重要，要么认为缓解疼痛是最重要的结果。
