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使用患者报告结局测量信息系统和兰德VSQ9量表来测量接受脊椎按摩疗法并采用韦伯斯特技术的孕妇的生活质量和特定就诊满意度。

The Use of the Patient Reported Outcomes Measurement Information System and the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients Under Chiropractic Care Utilizing the Webster Technique.

作者信息

Alcantara Joel, Nazarenko Andrea Lamont, Ohm Jeanne, Alcantara Junjoe

机构信息

1 The International Chiropractic Pediatric Association , Media, PA.

2 Department of Research, Life Chiropractic College West , Hayward, CA.

出版信息

J Altern Complement Med. 2018 Jan;24(1):90-98. doi: 10.1089/acm.2017.0162. Epub 2017 Dec 20.

Abstract

OBJECTIVE

To quantify the quality of life (QoL) and visit-specific satisfaction of pregnant women.

DESIGN

A prospective cohort within a practice-based research network (PBRN). Setting/Locations: Individual chiropractic offices.

SUBJECTS

Pregnant women (age ≥18 years) attending chiropractic care.

INTERVENTION(S): Chiropractic care (i.e., The Webster Technique, spinal adjustments, and adjunctive therapies).

MAIN OUTCOME MEASURES

The RAND VSQ9 to measure visit-specific satisfaction and the Patient Reported Outcomes Measurement Information System (PROMIS)-29 to measure QoL.

RESULTS

A convenience sample of 343 pregnant patients (average age = 30.96 years) comprised their study population. They were highly educated with 75% attaining a 2-year associate's degree or higher. The pregnant patients presented for chiropractic care with a mean week of gestation of 25.67 weeks (median = 28 weeks; range = 0-42 weeks) and parity (i.e., the number of live births) of 0.92 live births (median = 1; range = 0-6). From baseline (i.e., at study entrance with minimum first visit) and comparative (i.e., following a course of chiropractic care), the VSQ9 measurements revealed increasingly high satisfaction on the part of the subjects (i.e., the mean difference of baseline minus comparative measures = -0.7322; p < 0.005). The median number of visits (i.e., visits attended) at baseline and comparative measures was 1.00 (standard deviation [SD] = 22.69) and 3.30 (SD = 22.71), respectively. Across outcomes, QoL improved from baseline to comparative measurement after holding constant for visit number and time lapse, trimester of pregnancy, and care provider type. There was a reduction in mean T scores associated with fatigue (p < 0.05), pain interference (p < 0.05), sleep disturbance (p < 0.05), and an improvement in satisfaction with social roles (p < 0.05). A significant decrease was also found with pain interference (p < 0.05). No evidence was found that anxiety (p = 0.1404) or depression (p = 0.8785) changed.

CONCLUSION

A PBRN study was successfully implemented among chiropractors to find pregnant patients highly satisfied and their QoL scores improving with care beyond chance.

摘要

目的

量化孕妇的生活质量(QoL)和特定就诊满意度。

设计

基于实践的研究网络(PBRN)中的前瞻性队列研究。设置/地点:个体整脊诊所。

受试者

接受整脊治疗的孕妇(年龄≥18岁)。

干预措施

整脊治疗(即韦伯斯特技术、脊柱调整和辅助疗法)。

主要结局指标

使用RAND VSQ9量表测量特定就诊满意度,使用患者报告结局测量信息系统(PROMIS)-29量表测量生活质量。

结果

343名孕妇(平均年龄=30.96岁)的便利样本构成了研究人群。她们受教育程度较高,75%的人获得了两年制副学士学位或更高学历。孕妇接受整脊治疗时的平均孕周为25.67周(中位数=28周;范围=0-42周),产次(即活产数)为0.92次活产(中位数=1;范围=0-6)。从基线(即研究开始时,首次就诊最少)到对照期(即接受一个整脊治疗疗程后),VSQ9量表测量结果显示受试者的满意度越来越高(即基线测量值减去对照期测量值的平均差值=-0.7322;p<0.005)。基线期和对照期的就诊次数中位数(即实际就诊次数)分别为1.00次(标准差[SD]=22.69)和3.30次(SD=22.71)。在所有结局指标中,在对就诊次数、时间间隔、妊娠 trimester和护理提供者类型进行校正后,生活质量从基线期到对照期测量有所改善。与疲劳相关的平均T分数降低(p<0.05),疼痛干扰(p<0.05)、睡眠障碍(p<0.05),社会角色满意度提高(p<0.05)。疼痛干扰也有显著下降(p<0.05)。未发现焦虑(p=0.1404)或抑郁(p=0.8785)有变化。

结论

在整脊师中成功实施了一项PBRN研究,发现孕妇对治疗高度满意,且她们的生活质量得分在接受治疗后有非偶然的改善。

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