Santana Maria J, Tomkins Darrell J
Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, TRW Building, 3rd Floor, Calgary, Alberta, T2N 4Z6, Canada.
Department of Medical Genetics, University of Alberta, Edmonton, Canada.
J Patient Rep Outcomes. 2021 Jan 13;5(1):8. doi: 10.1186/s41687-020-00283-w.
The patient is the person who experiences both the processes and the outcomes of care. Information held by the patient is vital for clinical and self-management, improving health outcomes, delivery of care, organization of health systems, and formulation of health policies. Patient-reported outcome measures (PROMs) play an important role in supporting patient's self-management. This narrative describes a patient-led use of a PROM to self-manage after a rotator cuff injury.
This is a narrative of a patient who tore the supraspinatus tendon in her right shoulder in an accident. The Disabilities of the Arm, Shoulder and Hand, the DASH questionnaire, was used to monitor and self-manage recovery after the accident. The DASH questionnaire is a self-reported questionnaire that measures the difficulty in performing upper extremity activities and pain in the arm, shoulder or hand. It has been widely used in research studies, but here the patient initiated its use for self-management while waiting for and after rotator cuff surgery. The patient created separate sub-scale scores for function and for pain to answer questions from healthcare providers about her recovery.
There was noticeable improvement over 3 months of conservative treatment, from a high level of disability of 56 to 39 (score changed 17); however, the scores were nowhere near the general population normative score of 10.1. Surgery improved the score from 39 pre-surgery to 28. Post-surgical interventions included physiotherapy, pain management and platelet-riched plasma treatment (PRP). The score was 14 4 weeks post-PRP.
The patient found the DASH useful in monitoring recovery from a rotator cuff injury (before and after surgery). The DASH contributed to communication with healthcare professionals and supported the clinical management. The DASH questionnaire was able to capture the patient's experience with the injury and surgical recovery, corroborating an improvement in function while there was persistent post-surgical pain.
患者是经历医疗过程和结果的人。患者所掌握的信息对于临床和自我管理、改善健康结果、提供医疗服务、组织卫生系统以及制定卫生政策至关重要。患者报告结局测量（PROMs）在支持患者自我管理方面发挥着重要作用。本叙述描述了一名患者在肩袖损伤后自主使用PROM进行自我管理的情况。
这是一名患者的叙述，她在一次事故中右肩的冈上肌腱撕裂。使用上肢、肩部和手部功能障碍（DASH）问卷来监测事故后的恢复情况并进行自我管理。DASH问卷是一份自我报告问卷，用于测量进行上肢活动的困难程度以及手臂、肩部或手部的疼痛情况。它已在研究中广泛使用，但在此处，患者在等待肩袖手术期间及术后自主将其用于自我管理。患者为功能和疼痛分别创建了子量表分数，以回答医疗服务提供者关于其恢复情况的问题。
经过3个月的保守治疗，有明显改善，残疾程度从高水平的56降至39（分数变化了17）；然而，这些分数远未达到一般人群的标准分数10.1。手术将分数从术前的39提高到了28。术后干预包括物理治疗、疼痛管理和富血小板血浆治疗（PRP）。PRP治疗4周后分数为14。
患者发现DASH在监测肩袖损伤（手术前后）的恢复情况方面很有用。DASH有助于与医疗专业人员沟通并支持临床管理。DASH问卷能够捕捉患者的损伤和手术恢复经历，证实了功能有所改善，同时术后疼痛持续存在。
