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由物理治疗师和执业护士协调的创新护理模式在专科护理中用于髋膝关节骨关节炎:一项前瞻性研究。

An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.

机构信息

Department of Medical Decision Making, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.

出版信息

Rheumatol Int. 2013 Jul;33(7):1821-8. doi: 10.1007/s00296-012-2662-3. Epub 2013 Jan 17.

DOI:10.1007/s00296-012-2662-3
PMID:23325095
Abstract

The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.

摘要

研究主题是调查经过物理治疗师和执业护师协调的专家护理干预后,髋或膝关节骨关节炎(OA)患者的健康相关生活质量(HRQoL)、疼痛和功能是否得到改善,并评估他们在 12 周时对这种护理的满意度。这项观察性研究纳入了所有转诊至门诊骨科诊所的髋或膝关节 OA 连续患者。干预措施包括一次标准化就诊(评估和个性化的管理建议,在初级保健中执行)和电话随访,由物理治疗师和执业护师协调,与骨科医生合作进行。基线和 10 周后的评估包括简短形式 36 项健康调查(SF-36)、欧洲五维健康量表(EQ-5D)、髋或膝关节残疾和骨关节炎结局评分(HOOS 或 KOOS)、髋或膝关节间歇性和持续性骨关节炎疼痛问卷(ICOAP)以及多维满意度问卷(23 项;4 分制)。87 名患者(57 名女性),平均年龄 68 岁(SD 10.9),其中 63 名患者(72%)可获得随访数据。在 SF-36 生理总评分、EQ-5D、ICOAP 髋和膝关节评分、HOOS 运动亚量表和 KOOS 疼痛、症状和日常生活活动亚量表方面,均观察到统计学显著改善。每个项目报告满意度的患者比例从 79%到 98%不等。在髋和膝关节 OA 疼痛患者中,单次就诊多学科 OA 管理干预在专家护理中显著改善了疼痛、功能和 HRQoL,患者满意度高。

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Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.髋膝关节骨关节炎的物理治疗:关于初始评估、治疗和评估的实践指南的制定
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The Transmural Trauma Care Model (TTCM) for the rehabilitation of trauma patients is effective in improving patient related outcome measures: a non-randomized controlled trial.创伤患者康复的穿壁性创伤护理模式(TTCM)在改善患者相关结局指标方面有效:一项非随机对照试验。
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Osteoarthritis Cartilage. 2011 Feb;19(2):147-54. doi: 10.1016/j.joca.2010.10.025. Epub 2010 Oct 31.
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