Lee Ki-Beom, Lee Yoon Jae, Kim Me-Riong, Shin Kyung-Min, Ha In-Hyuk
Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2020 Mar 19;2020:8195241. doi: 10.1155/2020/8195241. eCollection 2020.
This study aimed to assess the costs, health status, and medical service satisfaction with Korean and conventional medicine use before and after surgery of patients visiting Korean medicine hospitals for postsurgical musculoskeletal pain. The study population comprised patients who visited KM hospitals for the first time between June and November 2017 for persistent or recurrent pain and discomfort after low back, neck, shoulder, or knee surgery. Various validated questionnaires were used to collect data. A total of 100 participants were enrolled, and the majority had undergone low back surgery ( = 82). The participants had received 1.3 ± 0.7 magnetic resonance imaging (MRI) examinations and 2.4 ± 2.8 X-rays before surgery. Conventional interventions used before surgery were physical therapy (43%), medications (34%), and injections (28%), in descending order, while 48% of patients reported having received acupuncture 51.3 ± 81.1 times. The mean satisfaction score for surgery was 5.5 ± 2.8 points based on a 9-point Likert scale, while that for KM-based interventions was 6.3 ± 1.7 points. With respect to health-related information, the mean scores were 6.0 ± 2.2 points on the Numeric Rating Scale (NRS), 0.6 ± 0.2 points on the 5-Level EuroQol-5 Dimension (EQ-5D-5L), and 15.3 ± 10.2 on Beck's Depression Index II (BDI-II). The mean score on the Oswestry Disability Index (ODI) in patients with low back pain was 40.1 ± 19.2 points. Work impairment, as measured using the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH), was 62.5 ± 47.8%, while activity impairment was 5.9 ± 2.6%. Participants tended to show low satisfaction regarding surgery and high preference for KM-based interventions. In particular, low back surgery patients reported high ODI scores, indicating high dysfunctional levels and poor prognosis after surgery. It can be inferred that it is therefore important to provide appropriate presurgical and postsurgical care for patients with musculoskeletal pain to improve pain, function, and quality of life.
本研究旨在评估在韩医医院就诊的术后肌肉骨骼疼痛患者在手术前后使用韩医和传统医学的费用、健康状况及医疗服务满意度。研究人群包括2017年6月至11月期间首次因腰、颈、肩或膝关节手术后持续或反复疼痛及不适而到韩医医院就诊的患者。使用了各种经过验证的问卷来收集数据。共招募了100名参与者,其中大多数人接受了腰椎手术(n = 82)。参与者在手术前接受了1.3±0.7次磁共振成像(MRI)检查和2.4±2.8次X光检查。手术前使用的传统干预措施按降序排列依次为物理治疗(43%)、药物治疗(34%)和注射治疗(28%),而48%的患者报告接受过51.3±81.1次针灸治疗。基于9分李克特量表,手术的平均满意度得分为5.5±2.8分,而基于韩医的干预措施的平均满意度得分为6.3±1.7分。关于健康相关信息,数字评分量表(NRS)的平均得分为6.0±2.2分,5级欧洲五维健康量表(EQ - 5D - 5L)的平均得分为0.6±0.2分,贝克抑郁量表第二版(BDI - II)的平均得分为15.3±10.2分。腰痛患者的奥斯威斯利残疾指数(ODI)平均得分为40.1±19.2分。使用工作效率和活动障碍问卷:总体健康(WPAI - GH)测量的工作障碍为62.5±47.8%,活动障碍为5.9±2.6%。参与者对手术的满意度往往较低,对基于韩医的干预措施的偏好较高。特别是,腰椎手术患者报告的ODI得分较高,表明功能障碍程度高且手术后预后较差。由此可以推断,因此为肌肉骨骼疼痛患者提供适当的术前和术后护理对于改善疼痛、功能和生活质量非常重要。