南美洲和越南医疗服务不足地区肌肉骨骼疾病的识别

Identification of musculoskeletal disorders in medically underserved regions of South America and Vietnam.

作者信息

Jacobs Robin J, Collias Belinda A, Rana Arif M, Wallace Elaine M, Kane Michael N, Boesler David R

机构信息

From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education

出版信息

J Am Osteopath Assoc. 2015 Jan;115(1):12-22. doi: 10.7556/jaoa.2015.003.

DOI:10.7556/jaoa.2015.003

PMID:25550488

Abstract

CONTEXT

Musculoskeletal disorders have been implicated as the leading cause of disability throughout the world, representing a high percentage of the disease burden in many nations. Anecdotal evidence suggests that musculoskeletal pain has become increasingly pervasive, especially among rural populations of developing countries.

OBJECTIVE

To characterize specific musculoskeletal disorders in medically underserved regions where these issues have not yet been thoroughly examined.

METHODS

The sample comprised adult residents receiving care during brief medical outreach trips to South America (Peru, Ecuador, and Argentina) and Vietnam from December 2010 to March 2013. Patients completed an anonymous questionnaire on musculoskeletal pain, self-reported health status, and health care-seeking behavior. Demographic information was also obtained.

RESULTS

In Vietnam, 295 patients aged 20 to 88 years (mean [SD], 59 [14.7] years) completed the survey, 204 (69%) of whom were women. In South America, 552 patients aged 18 to 86 years (mean [SD], 44 [17.24] years) completed the survey, 398 (72.1%) of whom were women. Among the Vietnamese patients, acute pain was most frequently felt in the knees (132 [44.7%]), which were also the most frequent site of chronic pain (122 [41.4%]). Among the South American patients, acute pain was felt most frequently in the lower back (225 [47%]), and the upper back (253 [46.6%]) was the most frequent site of chronic pain. Associations were found between sex and chronic pain, with women reporting more chronic pain than men in the shoulder (17 [53%] vs 15 [47%], respectively), upper back (85 [79%] vs 22 [21%]), hand/wrist (153 [85%] vs 52 [15%]), and knee (40 [80%] vs 7 [20%]). Men reported more acute knee pain than women (73 [48%] vs 148 [38%], respectively). For patients in both samples, acute pain was associated with chronic pain in the same location for all body parts (P<.01).

CONCLUSION

This study characterized specific musculoskeletal disorders in selected poor and underserved regions in Vietnam and South America. Owing to reported regional differences, the authors recommend that global treatment protocols be developed with a population-specific approach after conducting a needs assessment for musculoskeletal disorders.

摘要

背景

肌肉骨骼疾病被认为是全球致残的主要原因，在许多国家的疾病负担中占很高比例。轶事证据表明，肌肉骨骼疼痛已变得越来越普遍，尤其是在发展中国家的农村人口中。

目的

在这些问题尚未得到充分研究的医疗服务不足地区，对特定的肌肉骨骼疾病进行特征描述。

方法

样本包括2010年12月至2013年3月期间在前往南美洲（秘鲁、厄瓜多尔和阿根廷）和越南的短期医疗外展活动中接受治疗的成年居民。患者完成了一份关于肌肉骨骼疼痛、自我报告的健康状况和寻求医疗行为的匿名问卷。还获取了人口统计学信息。

结果

在越南，295名年龄在20至88岁（平均[标准差]，59[14.7]岁）的患者完成了调查，其中204名（69%）为女性。在南美洲，552名年龄在18至86岁（平均[标准差]，44[17.24]岁）的患者完成了调查，其中398名（72.1%）为女性。在越南患者中，膝盖是急性疼痛最常出现的部位（132例[44.7%]），也是慢性疼痛最常出现的部位（122例[41.4%]）。在南美洲患者中，下背部是急性疼痛最常出现的部位（225例[47%]），而上背部是慢性疼痛最常出现的部位（253例[46.6%]）。发现性别与慢性疼痛之间存在关联，女性在肩部（分别为17例[53%]对15例[47%]）、上背部（85例[79%]对22例[21%]）、手/腕部（153例[85%]对52例[15%]）和膝盖（40例[80%]对7例[20%]）报告的慢性疼痛比男性多。男性报告的急性膝盖疼痛比女性多（分别为73例[48%]对148例[38%]）。对于两个样本中的患者，所有身体部位的急性疼痛均与同一部位的慢性疼痛相关（P<0.01）。