Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
Pain Pract. 2020 Mar;20(3):247-254. doi: 10.1111/papr.12845. Epub 2019 Nov 11.
INTRODUCTION: Due to the difficulties encountered in the treatment process of patients with chronic pain, it is of utmost importance to involve patients themselves in their rehabilitation trajectory. Patient engagement can be obtained by motivating patients to select their own treatment goals. We hypothesize that applying goal setting, as a form of patient empowerment, in potential candidates for spinal cord stimulation (SCS) may further improve the outcome of SCS. As a first step in creating patient empowerment, patients' goals that they aim to achieve with SCS will be explored. METHODS: Fifteen patients suffering from failed back/neck surgery syndrome and scheduled for SCS were interviewed in depth. All interviews were audio recorded and analyzed using in vivo coding. Afterwards, the International Classification of Functioning, Disability and Health framework was used to structure the responses of patients. RESULTS: In the domain of bodily functions, all patients mentioned pain reduction, and 1 patient wanted to regain his previous sleep pattern. In the domain of activities, walking, sitting, driving a car, bending down, and picking up were the highest ranked goals. Regaining a social life was the highest ranked goal for participation. Eleven patients wanted to regain a feeling of happiness, and 5 patients wanted to focus on avoiding depression. CONCLUSION: The interviews revealed a broad spectrum of individual patients' goals, highlighting the need of individually targeted rehabilitation trajectories in the field of neuromodulation. Goal identification could entail the first step towards individualized medicine in the SCS trajectory.
引言:由于慢性疼痛患者在治疗过程中遇到的困难,让患者参与到自己的康复轨迹中至关重要。通过激励患者选择自己的治疗目标,可以实现患者的参与。我们假设,在脊髓刺激(SCS)的潜在候选者中应用目标设定,作为一种赋予患者权力的形式,可能会进一步改善 SCS 的结果。作为创造患者赋权的第一步,将探讨患者希望通过 SCS 实现的目标。
方法:对 15 名患有失败的背部/颈部手术综合征并计划接受 SCS 的患者进行了深入访谈。所有访谈均进行了音频记录,并使用现场编码进行了分析。之后,使用国际功能、残疾和健康分类框架对患者的回答进行了结构分析。
结果:在身体功能领域,所有患者都提到了减轻疼痛,有 1 位患者希望恢复以前的睡眠模式。在活动领域,行走、坐、开车、弯腰和捡拾是排名最高的目标。重新融入社会生活是参与的最高目标。11 名患者希望重新获得幸福感,5 名患者希望避免抑郁。
结论:访谈揭示了患者个体目标的广泛范围,突出了在神经调节领域需要针对个体的康复轨迹。目标识别可能是 SCS 轨迹中个体化医学的第一步。