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全膝关节置换术后使用应对清单的职业治疗:病例系列

Occupational Therapy Using Coping Lists After Total Knee Arthroplasty: A Case Series.

作者信息

Hara Ryusei, Hiraga Yuki, Hirakawa Yoshiyuki

机构信息

Department of Rehabilitation, Fukuoka Rehabilitation Hospital, Fukuoka, JPN.

Department of Health Care Administration and Management, Graduate School of Kyushu University, Fukuoka, JPN.

出版信息

Cureus. 2022 Jul 27;14(7):e27374. doi: 10.7759/cureus.27374. eCollection 2022 Jul.

Abstract

Total knee arthroplasty (TKA) can improve the postoperative quality of life in patients with severe knee osteoarthritis. Although occupational therapy (OT) using a coping list may be useful for post-TKA patients, its use has not been documented. This study aimed to explore the effectiveness of OT using coping skills. Five post-TKA patients underwent OT using coping skills. The Canadian Occupational Performance Measure (COPM), numerical rating scale (NRS), Hospital Anxiety and Depression Scale (HADS), EQ-5D (EuroQol-5-dimension)-5-level (5L), EQ-5D Visual Analogue Scale (VAS), modified fall efficacy scale (MFES), Pain Disability Assessment Scale (PDAS), and coping skills were measured at the start and end of the study. Significant improvements were observed in COPM, NRS, HADS, EQ-5D-5L, and PDAS scores (p <0.05). No significant improvements were found in the EQ-5D VAS and MFES scores. All evaluations showed a large effect size (r ≤ 0.5). The total number of coping skills also increased. This report suggests that OT with coping strategies is effective for pain, psychological factors, quality of life, and activities of daily living. Incorporating coping skills in OT may be useful in postoperative TKA pain management. However, larger studies are needed to validate this.

摘要

全膝关节置换术(TKA)可改善重度膝骨关节炎患者术后的生活质量。尽管使用应对清单的职业疗法(OT)可能对TKA术后患者有用,但其应用尚未有文献记载。本研究旨在探讨运用应对技巧的职业疗法的有效性。五名TKA术后患者接受了运用应对技巧的职业疗法。在研究开始和结束时,测量了加拿大职业表现测量量表(COPM)、数字评定量表(NRS)、医院焦虑抑郁量表(HADS)、EQ-5D(欧洲五维健康量表)-5级(5L)、EQ-5D视觉模拟量表(VAS)、改良跌倒效能量表(MFES)、疼痛残疾评估量表(PDAS)以及应对技巧。观察到COPM、NRS、HADS、EQ-5D-5L和PDAS评分有显著改善(p<0.05)。EQ-5D VAS和MFES评分未发现显著改善。所有评估均显示出较大的效应量(r≤0.5)。应对技巧的总数也有所增加。本报告表明,采用应对策略的职业疗法对疼痛、心理因素、生活质量和日常生活活动有效。在职业疗法中融入应对技巧可能有助于TKA术后疼痛管理。然而,需要更大规模的研究来验证这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e66/9418618/65b717c4c39a/cureus-0014-00000027374-i01.jpg

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