Health, Aarhus University, Aarhus, Denmark.
BMC Musculoskelet Disord. 2013 Jul 30;14:225. doi: 10.1186/1471-2474-14-225.
Knee pain is common during adolescence. Adolescents and their parents may think that knee pain is benign and self-limiting and therefore avoid seeking medical care. However, long-term prognosis of knee pain is not favourable and treatment seems to offer greater reductions in pain compared to a "wait-and-see" approach. The purpose of this study was to describe the determinants of care-seeking behaviour among adolescents with current knee pain and investigate what types of treatment are initiated.
An online questionnaire was forwarded to 2,846 adolescents aged 15-19 in four upper secondary schools. The questionnaire contained questions on age, gender, height, weight, currently painful body regions, frequency of knee pain, health-related quality of life measured by the EuroQol 5-dimensions, sports participation and if they had sought medical care. Adolescents who reported current knee pain at least monthly or more frequently were telephoned. The adolescents were asked about pain duration, onset of knee pain (traumatic or insidious) and if they were currently being treated for their knee pain.
504 adolescents currently reported at least monthly knee pain. 59% of these had sought medical care and 18% were currently under medical treatment . A longer pain duration and higher pain severity increased the odds of seeking medical care. Females with traumatic onset of knee pain were more likely to have sought medical care than females with insidious onset of knee pain. Females with traumatic onset of knee pain and increased pain severity were more likely to be undergoing medical treatment. The most frequently reported treatments were the combination of exercises and orthotics (68% of those undergoing medical treatment).
Females with insidious onset of knee pain do not seek medical care as often as those with traumatic onset and adolescents of both genders with insidious onset are less likely to be under medical treatment. These findings are important as knee pain with insidious onset has similar consequences as knee pain with traumatic onset regarding pain severity, pain duration and reductions in health-related quality of life.
青少年中常见膝关节疼痛。青少年及其家长可能认为膝关节疼痛是良性的、自限性的,因此避免就医。然而,膝关节疼痛的长期预后并不理想,治疗似乎比“观望”方法更能减轻疼痛。本研究旨在描述有膝关节疼痛的青少年寻求医疗服务的决定因素,并调查启动了哪些类型的治疗。
我们向四所高中的 2846 名 15-19 岁青少年在线发送了一份调查问卷。问卷内容包括年龄、性别、身高、体重、当前疼痛身体部位、膝关节疼痛频率、用欧洲五维健康量表(EuroQol 5-dimensions)测量的健康相关生活质量、运动参与情况以及是否寻求过医疗服务。报告至少每月或更频繁膝关节疼痛的青少年将接受电话访谈。询问青少年膝关节疼痛的持续时间、膝关节疼痛的开始(创伤性或隐匿性)以及他们是否正在接受膝关节疼痛的治疗。
504 名青少年目前报告至少每月膝关节疼痛一次。其中 59%的人寻求过医疗服务,18%的人正在接受治疗。疼痛持续时间较长和疼痛程度较高增加了寻求医疗服务的可能性。创伤性膝关节疼痛发作的女性比隐匿性膝关节疼痛发作的女性更有可能寻求医疗服务。创伤性膝关节疼痛发作且疼痛程度较高的女性更有可能接受治疗。最常报告的治疗方法是结合运动和矫形器(接受治疗者的 68%)。
隐匿性膝关节疼痛发作的女性不像创伤性膝关节疼痛发作的女性那样经常寻求医疗服务,而且男女两性隐匿性膝关节疼痛发作的青少年接受医疗治疗的可能性较小。这些发现很重要,因为隐匿性膝关节疼痛发作与创伤性膝关节疼痛发作在疼痛严重程度、疼痛持续时间和健康相关生活质量下降方面具有相似的后果。