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COVID-19大流行期间患者与医生对肌肉骨骼疾病紧急程度认知的差异

Differences in Patient and Physician Perceptions of Urgency for Musculoskeletal Conditions During the COVID-19 Pandemic.

作者信息

Antonacci Christopher L, Omari Ali M, Zaifman Jay, Baig Ayesha F, Sommi Corinne P, Medvedev Gleb, Savoie Felix H, Sethi Paul M, Klein Gregg R, Koerner John D, Alberta Frank G

出版信息

Orthopedics. 2021 Jul-Aug;44(4):e534-e538. doi: 10.3928/01477447-20210618-13. Epub 2021 Jul 1.

Abstract

In 2020, the coronavirus disease 2019 (COVID-19) pandemic limited musculoskeletal care to urgent or "nonelective" office visits and procedures. No guidelines exist to inform patients or physicians what meets these criteria. The purpose of this multi-institutional study was to describe the differences in perceptions of urgency for musculoskeletal complaints between patients and providers during the COVID-19 pandemic. An anonymous survey was distributed to patients who visited the authors' orthopedic clinics in January and February 2020 and practicing orthopedic surgeons. The surveys were administered in May 2020 after COVID-19 was officially labeled a pandemic and included questions regarding demographic information and perceptions of orthopedic urgency. A total of 1491 patients and 128 physicians completed the surveys. A significantly higher percentage of physicians considered the following diagnoses an appropriate indication for an urgent visit compared with patients: fracture (<.001), acute dislocation (<.001), infection (<.001), neurologic compromise (<.001), tumor (<.001), acute tendon injury (<.001), weakness (<.001), inability to bear weight (<.001), post-surgical problem (<.001), and painful joint effusion (<.001). There were no significant differences in the perception of urgency for the following conditions: bursitis/tendonitis (=1.00), joint/extremity deformity without pain (=.113), and loss of range of motion of a joint (=.467). Younger patients and those with higher levels of education were significantly more likely to consider their conditions urgent. Patients may require additional education to prevent delay in treatment of urgent conditions-especially time-sensitive conditions such as neurologic compromise, tumors, and infections-when access to physicians is limited. [. 2021;44(4):e534-e538.].

摘要

2020年,2019冠状病毒病(COVID-19)大流行将肌肉骨骼疾病的治疗限制在紧急或“非选择性”的门诊就诊和手术。目前尚无指导方针告知患者或医生哪些情况符合这些标准。这项多机构研究的目的是描述COVID-19大流行期间患者和医疗服务提供者对肌肉骨骼疾病投诉紧迫性的认知差异。对2020年1月和2月就诊于作者所在骨科诊所的患者以及执业骨科医生进行了一项匿名调查。该调查于2020年5月进行,当时COVID-19已被正式列为大流行病,调查内容包括人口统计学信息以及对骨科疾病紧迫性的认知。共有1491名患者和128名医生完成了调查。与患者相比,有显著更高比例的医生认为以下诊断适合紧急就诊:骨折(<.001)、急性脱位(<.001)、感染(<.001)、神经功能受损(<.001)、肿瘤(<.001)、急性肌腱损伤(<.001)、无力(<.001)、无法负重(<.001)、术后问题(<.001)以及疼痛性关节积液(<.001)。对于以下情况的紧迫性认知没有显著差异:滑囊炎/肌腱炎(P = 1.00)、无痛性关节/肢体畸形(P =.113)以及关节活动范围丧失(P =.467)。年轻患者和受教育程度较高的患者更有可能认为自己的病情紧急。在就医受限的情况下,患者可能需要接受更多教育,以防止延误紧急病情的治疗,尤其是对时间敏感的病情,如神经功能受损、肿瘤和感染。[《. 2021;44(4):e534 - e538.》]

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