Aciksoz Semra, Akyuz Aygul, Tunay Servet
Fundamentals of Nursing Department, Faculty of Nursing, University of Health Sciences, Istanbul, Turkey.
Department of Obstetrics and Gynecology Nursing, School of Nursing, Koç University, Istanbul, Turkey.
J Clin Nurs. 2017 Dec;26(23-24):5179-5190. doi: 10.1111/jocn.14070. Epub 2017 Oct 10.
To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients.
Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy.
A randomised clinical trial design.
The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile (NHP) and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life.
We found decreased primary measurement pain scores and improved functional status scores and quality of life scores after the application programme compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality-of-life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement ([p < .001, χ = 48.000; p < .001, χ = 34.000], [p < .001, χ = 22.000; p = .001 χ =14.000] and [p = .005, χ = 16.000; p = .001, χ = 12.500]). There was no difference in the perceived pain, functional status and quality of life between the pre-application, postapplication and 2 weeks postapplication periods of the individuals in three groups (p > .05).
It was found that both hot and cold application resulted in a mild improvement in pain, functional status and quality of life, but this improvement was not sufficient to create a significant difference between the groups.
This study contributes to the literature on hot and cold application methods as self-management strategies for patients with knee osteoarthritis.
探讨自我实施的浅表局部热疗与冷疗对原发性膝骨关节炎患者疼痛、功能状态及生活质量的影响。
浅表局部热疗与冷疗作为治疗膝骨关节炎的非药物方法。然而，各种膝骨关节炎管理指南对热疗和冷疗的推荐相互矛盾。
随机临床试验设计。
样本包括96例被诊断为原发性膝骨关节炎的患者。在应用阶段，患者被分配到热疗组和冷疗组，在接受标准骨关节炎治疗的同时，每天进行两次热疗和冷疗，持续3周。对照组仅采用标准骨关节炎治疗。通过描述性信息表、疼痛量表、WOMAC骨关节炎指数、诺丁汉健康概况（NHP）和患者满意度评估表收集数据。结果指标包括疼痛强度、功能状态和生活质量。
我们发现，与应用前阶段相比，热疗组和冷疗组在应用方案后，主要测量疼痛评分降低，功能状态评分和生活质量评分提高。应用完成后，第二次测量时的疼痛评分、功能状态评分和生活质量评分在统计学上仍低于应用前评分，但高于第一次测量（[p <.001，χ = 48.000；p <.001，χ = 34.000]，[p <.001，χ = 22.000；p =.001，χ = 14.000]和[p =.005，χ = 16.000；p =.001，χ = 12.500]）。三组个体在应用前、应用后和应用后2周期间的疼痛感受、功能状态和生活质量无差异（p >.05）。
发现热疗和冷疗均使疼痛、功能状态和生活质量有轻度改善，但这种改善不足以在组间产生显著差异。
本研究为膝骨关节炎患者自我管理策略的热疗和冷疗应用方法文献做出了贡献。
