Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden.
J Rehabil Med. 2020 Feb 27;52(2):jrm00019. doi: 10.2340/16501977-2648.
To investigate prognostic factors for physical and emotional functioning following interdisciplinary multimodal pain rehabilitation, by targeting patients' baseline characteristics and health measures.
A prospective cohort of 2,876 patients from 38 specialist clinics across Sweden, who were completing interdisciplinary multimodal pain rehabilitation programmes, was followed through the Swedish Quality Registry for Pain Rehabilitation, from initial assessment to 12-month follow-up. Using logistic regression, baseline data were regressed to predict improvement in Physical functioning and Emotional functioning, fused by principal component analyses using the 36-item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS).
Employment status emerged as having the largest effect sizes in both Physical functioning and Emotional functioning; Working: odds ratio (OR) 2.05 (95% confidence interval (95% CI) 1.64-2.56) and OR 1.59 (95% CI 1.27-1.98), respectively. Strong beliefs in restored health, better initial emotional health, lower levels of pain and pain interference, and younger age all predicted Physical functioning. European origin, higher levels of general activity, and sense of life control all predicted Emotional functioning. Worse initial physical and emotional health predicted the corresponding dependent outcomes.
Employment was consistently found to be an important prognostic factor, suggesting the significance of avoiding delay in interdisciplinary multimodal pain rehabilitation. A positive treatment expectancy was of importance. In general, multidimensional measures indicated that better initial status was more favourable; however, inconsistency implies a complex prognostic picture.
通过针对患者的基线特征和健康指标，研究跨学科多模式疼痛康复后身体和情绪功能的预后因素。
一项前瞻性队列研究纳入了来自瑞典 38 个专家诊所的 2876 名患者，他们正在接受跨学科多模式疼痛康复计划，通过瑞典疼痛康复质量登记处进行随访，从初始评估到 12 个月的随访。使用逻辑回归，将基线数据回归以预测身体功能和情绪功能的改善，使用 36 项简短健康调查（SF-36）和医院焦虑抑郁量表（HADS）进行主成分分析融合。
就业状况在身体功能和情绪功能中都具有最大的效应量；在职：比值比（OR）分别为 2.05（95%置信区间（95%CI）1.64-2.56）和 1.59（95%CI 1.27-1.98）。对恢复健康的强烈信念、较好的初始情绪健康、较低的疼痛水平和疼痛干扰，以及较年轻的年龄都预测了身体功能。欧洲血统、较高的一般活动水平和生活控制感都预测了情绪功能。初始身体和情绪健康较差预测了相应的依赖结果。
就业被一致认为是一个重要的预后因素，这表明避免在跨学科多模式疼痛康复中延迟的重要性。积极的治疗预期很重要。一般来说，多维测量表明初始状态越好越有利；然而，不一致性暗示预后情况复杂。
