Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway -
Faculty of Medicine, University of Oslo, Oslo, Norway -
Eur J Phys Rehabil Med. 2017 Dec;53(6):936-943. doi: 10.23736/S1973-9087.17.04608-1. Epub 2017 May 23.
In musculoskeletal research, patients' expectations have recently received increased attention. However, few prospective studies have investigated these expectations or their prognostic significance and possible clinical value.
To investigate the influence of patients' expectations on improvements in pain and functional status six months after an outpatient physical medicine assessment.
Prospective cohort study.
Physical Medicine and Rehabilitation (PMR) outpatient clinic.
Patients with neck, back, or shoulder complaints.
Pain, during rest and activity, and functional status (PainFunction) were assessed using numerical rating scales (NRSs; 0 to 11) prior to a PMR consultation and after six months. At baseline, the patients were asked to define their expectations (Exp) regarding pain and functional status at six months using equivalent NRSs. The influence of Exp on PainFunction at six months was assessed through multiple regression analysis, controlling for demographic factors.
A total of 256 patients were included between January and June 2013, and 181 were followed up at six months. PainFunction improved statistically significant between baseline and six months (P<0.001). Approximately 40% of the patients expected (Exp) an improvement, while 29% reported an improvement at six months, reflected by a minimum of two points improvement in PainFunction. The regression analysis revealed that sick leave and the number of pain sites, but not expectations (Exp), influenced improvement in PainFunction at six months.
The present study does not support the suggested influence of expectations on pain and functional improvement in patients with neck, back or shoulder complaints.
The patients' expectations were more positive than their actual pain and functional improvements. However, their expectations did not significantly influence the study outcomes.
在肌肉骨骼研究中，患者的期望最近受到了更多的关注。然而，很少有前瞻性研究调查这些期望或其预后意义和可能的临床价值。
调查患者的期望对门诊物理医学评估后 6 个月疼痛和功能状态改善的影响。
前瞻性队列研究。
物理医学与康复（PMR）门诊。
有颈部、背部或肩部疼痛的患者。
在 PMR 咨询之前和 6 个月后，使用数字评分量表（NRS；0 到 11）评估疼痛、休息时和活动时的疼痛以及功能状态（PainFunction）。在基线时，患者被要求使用等效的 NRS 来定义他们对 6 个月时疼痛和功能状态的期望（Exp）。通过多元回归分析，控制人口统计学因素，评估 Exp 对 6 个月时 PainFunction 的影响。
2013 年 1 月至 6 月期间共纳入 256 例患者，181 例患者在 6 个月时进行了随访。PainFunction 在基线和 6 个月之间有统计学意义的改善（P<0.001）。约 40%的患者期望（Exp）有所改善，而 29%的患者在 6 个月时报告有改善，反映为 PainFunction 至少改善了 2 分。回归分析显示，病假和疼痛部位的数量，而不是期望（Exp），影响了 6 个月时 PainFunction 的改善。
本研究不支持患者的期望对颈部、背部或肩部疼痛患者的疼痛和功能改善有影响的观点。
患者的期望比他们实际的疼痛和功能改善更为积极。然而，他们的期望并没有显著影响研究结果。
