McNeely Emmanuel L, Sachdev Rahul, Rahman Rafa, Zhang Bo, Skolasky Richard L
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Orthop. 2021 Jun 18;26:8-13. doi: 10.1016/j.jor.2021.06.001. eCollection 2021 Jul-Aug.
To investigate the associations of sociodemographic characteristics and PROMIS domain scores with patient activation among patients presenting for spine surgery at a university-affiliated spine center.
Patients completed a survey collecting demographic and social information. Patients also completed the Patient-Reported Outcomes Measurement Information System (PROMIS) and Patient Activation Measure questionnaires. The associations of PROMIS scores and sociodemographic characteristics with patient activation were assessed using linear and ordinal logistic regression (patient activation stage as ordinal).
A total of 1018 patients were included. Most respondents were white (84%), married (73%), and female (52%). Patients were distributed among the 4 activation stages as follows: stage I, 7.7%; stage II, 12%; stage III, 26%; and stage IV, 55%. Mean (±standard deviation) patient activation score was 70 ± 17 points. Female sex (adjusted coefficient [AC] = 4.3; 95% confidence interval [CI] 2.1, 6.4) and annual household income >$80,000 (OR = 3.7; 95% CI 0.54, 6.9) were associated with higher patient activation scores. Lower patient activation scores were associated with worse PROMIS Depression (AC = -0.31; 95% CI -0.48, -0.14), Fatigue (OR = -0.19; 95% CI -0.33, -0.05), Pain (OR = 0.22; 95% CI 0.01, 0.43), and Social Satisfaction (OR = 0.33; 95% CI 0.14, 0.51) scores.
Depression and socioeconomic status, along with PROMIS Pain, Fatigue, and Social Satisfaction domains, were associated with patient activation. Patients with a greater burden of depressive symptoms had lower patient activation; conversely, women and those with higher income had greater patient activation.
Level 1.
研究在一所大学附属脊柱中心接受脊柱手术的患者中，社会人口学特征和患者报告结果测量信息系统（PROMIS）领域得分与患者激活度之间的关联。
患者完成一项收集人口统计学和社会信息的调查。患者还完成了患者报告结果测量信息系统（PROMIS）和患者激活度测量问卷。使用线性和有序逻辑回归（将患者激活阶段作为有序变量）评估PROMIS得分和社会人口学特征与患者激活度之间的关联。
共纳入1018例患者。大多数受访者为白人（84%）、已婚（73%）、女性（52%）。患者在4个激活阶段的分布如下：第一阶段，7.7%；第二阶段，12%；第三阶段，26%；第四阶段，55%。患者激活度平均（±标准差）得分为70±17分。女性（调整系数[AC]=4.3；95%置信区间[CI]2.1，6.4）和家庭年收入>80,000美元（OR=3.7；95%CI0.54，6.9）与较高的患者激活度得分相关。较低的患者激活度得分与较差的PROMIS抑郁（AC=-0.31；95%CI-0.48，-0.14）、疲劳（OR=-0.19；95%CI-0.33，-0.05）、疼痛（OR=0.22；95%CI0.01，0.43）和社会满意度（OR=0.33；95%CI0.14，0.51）得分相关。
抑郁和社会经济状况，以及PROMIS疼痛、疲劳和社会满意度领域与患者激活度相关。抑郁症状负担较重的患者激活度较低；相反，女性和收入较高者的患者激活度较高。
1级。
