van Dijk Pim A D, Bot Arjan G J, Neuhaus Valentin, Mudgal Chaitanya S, Ring David
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA ; Harvard Medical School, Boston, USA.
Hand (N Y). 2014 Mar;9(1):67-74. doi: 10.1007/s11552-013-9546-1.
Patient expressions reflect disability and psychological factors. The aim of this study was to list common phrases and feelings in hand surgery practice and to prospectively study the correlation of these phrases and to correlate them with possible associated feelings and disability.
Eighty-three patients completed the short version of the disabilities of arm, shoulder and hand (QuickDASH) questionnaire to measure disability, the pain self-efficacy questionnaire (PSEQ) to study coping, and a pain scale. The patients also completed the phrases and feelings questionnaire, which list verbal expressions patients often use. Pearson's correlation was used to test the correlation of continuous variables, and independent t test and one-way ANOVA were used for categorical variables. All variables with p < 0.08 were inserted in a multivariable regression.
There was a large correlation between the individual phrases and feelings questions with PSEQ and QuickDASH. The best model for the combined phrases questionnaire included pain, PSEQ, smoking, and other pain conditions. The best model for the combination of all the feelings questions included PSEQ, pain, and marital status. The best model for QuickDASH included phrases, PSEQ, prior treatment, and working status, with phrases being the strongest factor.
Patients use specific phrases that indicate the magnitude of their disability and the effectiveness of their coping strategies. Providers should respond to these phrases by empathetically acknowledging these aspects of the human illness experience.
患者的表达反映了残疾和心理因素。本研究的目的是列出手部外科手术实践中常见的表述和感受,并前瞻性地研究这些表述之间的相关性,以及将它们与可能相关的感受和残疾情况相关联。
83名患者完成了手臂、肩部和手部功能障碍简表(QuickDASH)问卷以测量残疾情况,完成了疼痛自我效能问卷(PSEQ)以研究应对方式,还完成了一份疼痛量表。患者们还完成了表述和感受问卷,该问卷列出了患者常用的言语表达。采用Pearson相关性分析来检验连续变量之间的相关性,对于分类变量则使用独立t检验和单因素方差分析。所有p < 0.08的变量都纳入多变量回归分析。
各个表述和感受问题与PSEQ和QuickDASH之间存在高度相关性。组合表述问卷的最佳模型包括疼痛、PSEQ、吸烟和其他疼痛状况。所有感受问题组合的最佳模型包括PSEQ、疼痛和婚姻状况。QuickDASH的最佳模型包括表述、PSEQ、既往治疗和工作状态,其中表述是最强的因素。
患者使用特定的表述来表明其残疾程度及其应对策略的有效性。医护人员应通过感同身受地认可人类疾病体验的这些方面来回应这些表述。