Silvemark Annika, Källmén Håkan, Molander Carl
Department of Neuroscience, Rehabilitation Medicine, Uppsala University Hospital , Uppsala , Sweden.
Ups J Med Sci. 2014 Aug;119(3):278-86. doi: 10.3109/03009734.2014.908252. Epub 2014 May 30.
Multidisciplinary rehabilitation programmes can improve physical functioning and help patients with long-term pain back to work. Little is known, however, of the extent to which such rehabilitation also affects life satisfaction, pain severity, and disability. We wanted to evaluate if a 5-week rehabilitation programme for patients with long-term pain improves life satisfaction and decreases pain severity and disability.
The subjects were 164 patients aged 18-65 years from a pain rehabilitation clinic. Most of them were referred from primary care units. One group of repeated tests was used. Participants were asked to fill out the LiSat-11 checklist and parts of the Multidimensional Pain Inventory (MPI), including pain severity, at admission, at discharge, and 1 year after the rehabilitation programme.
Satisfaction with life as a whole, and six of ten LiSat-11 domains improved during the follow-up, though none reached the levels for the general population. MPI subscales pain severity, pain interference, life control, and affective distress improved, whereas no change was observed for general activity. Patients older than 38 years decreased more in MPI affective distress than younger patients. Gender, pain severity, and work status before the programme did not significantly influence the outcome.
The results indicate that multidisciplinary rehabilitation improves life satisfaction, reduces pain severity, and reduces negative psychological, social, and behavioural effects of pain. These outcome variables relate to domains known to be of interest for patients and should therefore be considered for evaluation of rehabilitation programmes for long-term pain.
多学科康复计划可改善身体机能,并帮助长期疼痛患者重返工作岗位。然而,对于此类康复在多大程度上还会影响生活满意度、疼痛严重程度和残疾状况,我们却知之甚少。我们希望评估一项为期5周的针对长期疼痛患者的康复计划是否能提高生活满意度并降低疼痛严重程度和残疾状况。
研究对象为来自一家疼痛康复诊所的164名年龄在18至65岁之间的患者。他们大多由初级保健单位转诊而来。采用一组重复测试。要求参与者在入院时、出院时以及康复计划结束后1年填写LiSat - 11清单和多维疼痛量表(MPI)的部分内容,包括疼痛严重程度。
在随访期间,整体生活满意度以及LiSat - 11的十个维度中的六个维度有所改善,尽管均未达到普通人群的水平。MPI分量表中的疼痛严重程度、疼痛干扰、生活控制和情感困扰有所改善,而一般活动方面未观察到变化。38岁以上患者的MPI情感困扰下降幅度大于年轻患者。项目实施前的性别、疼痛严重程度和工作状态对结果没有显著影响。
结果表明,多学科康复可提高生活满意度,降低疼痛严重程度,并减少疼痛的负面心理、社会和行为影响。这些结果变量与患者感兴趣的领域相关,因此在评估长期疼痛康复计划时应予以考虑。