Lowe Dianne B, Taylor Michael J, Hill Sophie J
From the Centre for Health Communication and Participation; and Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University; and School of Allied Health, Australian Catholic University, Melbourne, Australia.D.B. Lowe, BA, BSc, Grad Cert Ed., PhD Student, Research officer, Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University; M.J. Taylor, BPharm (Hons), LLB (Hons), Grad Dip Legal Prac, MSc, PhD, Senior Lecturer in Public Health, School of Allied Health, Australian Catholic University, and Editor, Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University; S.J. Hill, BA (Hons), MA, PhD, Head of Centre for Health Communication and Participation, and Co-ordinating Editor, Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University.
J Rheumatol. 2015 Aug;42(8):1484-93. doi: 10.3899/jrheum.140989. Epub 2015 May 1.
To estimate the prevalence of communication vulnerability (CV) and its association with various health measures among working-age Australians with musculoskeletal conditions (MSK). The various vulnerability characteristics may lead to inadequate communication between consumers and healthcare professionals.
Prevalence of CV among 18-64 year olds, with or without MSK, was analyzed using the Australian Bureau of Statistics' National Health Survey 2007-08 data. Associations between CV and measures of health complexity (accumulating multimorbidity and risk factors) and health burden (poorer self-rated health, psychological distress, and pain restricting work) in the MSK population were estimated using logistic regression. Further analyses were conducted for each vulnerability characteristic to determine the degree of association (crude and adjusted) with measures of interest.
CV were more prevalent in working-age Australians with MSK (65%) than those without (51%). Adjusted for age and sex among working-age Australians with at least 1 MSK, those with 1 or more CV were more likely to have multimorbidity [adjusted OR (aOR) = 1.8, 95% CI 1.5-2.2], lifestyle risk factors (aOR = 2.1, 95% CI 1.5-2.8), poorer self-rated health (aOR = 3.4, 95% CI 2.7-4.2), greater psychological distress (aOR = 2.9, 95% CI 2.3-3.7), and pain restricting employment (aOR = 1.7, 95% CI 1.4-2.1) compared with those without CV.
For working-age people, there is an association between MSK and CV. For those with MSK, CV were associated with increased likelihood of health complexity and burden. These findings have policy and clinical relevance. Research is needed to determine whether interventions that address these specific CV characteristics reduce the burden of disease within these populations.
评估沟通易损性（CV）在患有肌肉骨骼疾病（MSK）的澳大利亚工作年龄人群中的患病率及其与各种健康指标的关联。各种易损性特征可能导致患者与医疗保健专业人员之间沟通不足。
利用澳大利亚统计局2007 - 2008年全国健康调查数据，分析18 - 64岁有或无MSK人群中CV的患病率。使用逻辑回归估计MSK人群中CV与健康复杂性指标（累积多种疾病和风险因素）以及健康负担（较差的自评健康状况、心理困扰和限制工作的疼痛）之间的关联。针对每个易损性特征进行进一步分析，以确定与感兴趣指标的关联程度（粗关联度和调整后关联度）。
患有MSK的澳大利亚工作年龄人群中CV的患病率（65%）高于无MSK者（51%）。在至少患有一种MSK的澳大利亚工作年龄人群中，调整年龄和性别后，有1种或更多CV的人比无CV者更易患多种疾病[调整后比值比（aOR）= 1.8，95%置信区间1.5 - 2.2]、存在生活方式风险因素（aOR = 2.1，95%置信区间1.5 - 2.8）、自评健康状况较差（aOR = 3.4，95%置信区间2.7 - 4.2）、心理困扰更严重（aOR = 2.9，95%置信区间2.3 - 3.7）以及疼痛限制工作（aOR = 1.7，95%置信区间1.4 - 2.1）。
对于工作年龄人群，MSK与CV之间存在关联。对于患有MSK的人，CV与健康复杂性和负担增加的可能性相关。这些发现具有政策和临床意义。需要开展研究以确定针对这些特定CV特征的干预措施是否能减轻这些人群的疾病负担。
