Nicholas Paul, Hefford Cheryl, Tumilty Steve
School of Physiotherapy, University of Otago, Dunedin, New Zealand.
J Man Manip Ther. 2012 Aug;20(3):147-52. doi: 10.1179/2042618612Y.0000000006.
The Patient-Specific Functional Scale (PSFS) and the Numeric Pain Rating Scale (NPRS) are two measures which the Accident Compensation Corporation (ACC) of New Zealand have made compulsory for physiotherapists to record at a patients initial visit and discharge. Therefore, it is important to assess clinicians' compliance to this reporting requirement, and whether research results regarding effectiveness of these measures are transferable to the clinic.
A retrospective observational study that assessed compliance in recording these measures, and analyzed the changes in scores seen across 11 physiotherapy practices in New Zealand over a 12-month period.
Overall compliance rates of 51·8% [95% confidence interval (CI): 50·7-52·9] for PSFS and 51·9% (95% CI: 50·7-53·0) for NPRS were reported. These figures increase to 85·3% (95% CI: 82·0-88·6) PSFS; and 85·1% (95% CI: 81·7-88·4) NPRS, when a full discharge for the patient was made. Mean change in PSFS scores were 5·1 (95% CI: 5·0-5·1) points representing an 85·2% (95% CI: 84·1-86·3) change in total score.
The study has shown that when patients complete a prescribed course of rehabilitation, clinicians show good compliance in recording PSFS and NPRS. Change in PSFS score is, on average, above the minimal clinically important difference shown in previous studies.
患者特异性功能量表(PSFS)和数字疼痛评分量表(NPRS)是新西兰事故赔偿公司(ACC)强制要求物理治疗师在患者初次就诊和出院时记录的两项指标。因此,评估临床医生对这一报告要求的依从性,以及这些指标有效性的研究结果是否可应用于临床,具有重要意义。
一项回顾性观察研究,评估记录这些指标的依从性,并分析新西兰11家物理治疗机构在12个月期间的评分变化。
报告显示,PSFS的总体依从率为51.8%[95%置信区间(CI):50.7 - 52.9],NPRS的总体依从率为51.9%(95%CI:50.7 - 53.0)。当患者完全出院时,这些数字分别增至85.3%(95%CI:82.0 - 88.6)的PSFS依从率和85.1%(95%CI:81.7 - 88.4)的NPRS依从率。PSFS评分的平均变化为5.1(95%CI:5.0 - 5.1)分,占总分变化的85.2%(95%CI:84.1 - 86.3)。
该研究表明,当患者完成规定的康复疗程时,临床医生在记录PSFS和NPRS方面表现出良好的依从性。PSFS评分的变化平均高于先前研究中显示的最小临床重要差异。