Lo Yi-Fang, Huang Yu-Chu
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Department of Nursing, Fu Jen Catholic University, Taiwan, ROC.
Hu Li Za Zhi. 2017 Apr;64(2):117-123. doi: 10.6224/JN.000030.
Scoliosis is a common medical problem, with an incidence of between 0.47% and 5.2% in the general population globally. Adolescent idiopathic scoliosis (AIS) accounts for nearly 80% of all scoliosis. Young people with AIS often experience negative social consequences in association with their condition. Without proper and timely treatment, the potential resulting disabilities range from trunk deformity, pain, and neurological complications to compromised cardiopulmonary function, all of which may cause lifelong suffering. Scoliosis may be treated either conservatively or surgically, based on the severity of the disease. Bracing is the most widely adopted method of conservative treatment. However, the main goal of bracing is to inhibit the progression of the spinal curvature rather than to cure scoliosis. The clinical effectiveness of bracing in Taiwan has often been underutilized as a result of financial or other factors such as the availability of the treatment. The purpose of the present review is to clarify the effectiveness of bracing for AIS by elucidating the pathophysiology of scoliosis and examining the recent clinical evidence. The importance of preventative care and the unique contribution of nursing care to treatment has to date been under-recognized. The positive support that nurses provide to the families of the patients during the early phases of treatment as well as to the patients themselves, including helping them exercise appropriately and wear the brace correctly, is an essential component of effective treatment. Learning how to work with and to adapt to the brace being part of the body is an important part of the treatment as well as a way to avoid pain. Nurses are in an ideal position to facilitate this learning process and, overall, to provide health education.
脊柱侧弯是一种常见的医学问题，在全球普通人群中的发病率为0.47%至5.2%。青少年特发性脊柱侧弯（AIS）占所有脊柱侧弯病例的近80%。患有AIS的年轻人常常因其病情而遭受负面的社会影响。若未得到及时恰当的治疗，可能导致的残疾包括躯干畸形、疼痛、神经并发症以及心肺功能受损，所有这些都可能造成终身痛苦。脊柱侧弯可根据疾病的严重程度采用保守治疗或手术治疗。支具治疗是最广泛采用的保守治疗方法。然而，支具治疗的主要目标是抑制脊柱侧弯的进展，而非治愈脊柱侧弯。由于经济或其他因素，如治疗资源的可及性，台湾地区支具治疗的临床效果常常未得到充分利用。本综述的目的是通过阐明脊柱侧弯的病理生理学并审视近期的临床证据，来明确支具治疗对AIS的有效性。迄今为止，预防性护理的重要性以及护理对治疗的独特贡献尚未得到充分认识。护士在治疗早期为患者家属以及患者本人提供的积极支持，包括帮助他们适度锻炼和正确佩戴支具，是有效治疗的重要组成部分。学习如何与支具配合并适应其成为身体的一部分，既是治疗的重要环节，也是避免疼痛的一种方式。护士处于促进这一学习过程并全面提供健康教育的理想位置。
