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从个体化治疗目标到骨关节炎的个体化康复:使用世界卫生组织国际功能、残疾和健康分类进行的纵向前瞻性映射研究。

From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health.

机构信息

Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.

Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.

出版信息

Ann Med. 2022 Dec;54(1):2816-2827. doi: 10.1080/07853890.2022.2131326.

Abstract

BACKGROUND/OBJECTIVE(S)/INTRODUCTION: In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF).

PATIENTS/MATERIALS AND METHODS: A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals.

RESULTS

In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women ( = 0.009). The majority of the "" goals (51%) and "" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up.

CONCLUSION(S): As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.

摘要

背景/目的/引言:在临床实践中,治疗目标往往是在没有探讨患者真正需求的情况下设定的。因此,我们收集了骨关节炎(OA)患者的个体化治疗目标,对其进行分类并映射到世界卫生组织国际功能、残疾和健康分类(ICF)。

患者/材料和方法:进行了一项纵向前瞻性队列研究(2019-2021 年)。我们使用了描述性统计和 Chi/Fisher 精确检验(如果适用),以及 Kruskal-Wallis 检验来分析患者目标的平均得分等级。

结果

共分析了 132 名参与者报告的 305 个目标(267 名女性 vs. 38 名男性)。排名前三的 ICF 类别是疼痛感觉(ICF:b280)、关节活动度(ICF:b710)和肌肉力量功能(ICF:b730)。总体而言,3 个月后 51%的患者报告的功能目标得到了实现。男性比女性更有可能实现他们的目标(=0.009)。大多数“期望”(51%)和“希望”(57%)目标没有得到改善。目标的平均得分等级在基线和随访之间存在显著差异。

结论

随着全球人类寿命的延长和受 OA 影响的人数增加,人们越来越需要识别和评估与 OA 患者相关的康复结果。

关键信息

患者和医疗保健提供者之间的“治疗目标协议”是迈向更个性化精准医学的一步,最终将导致更好的报告功能和健康结果。在骨关节炎患者中,可以使用目标实现量表(Goal Attainment Scale)仪器在不同时间点测量健康结果,其内容可以与 ICF 相关联,提供统一的语言和概念科学基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd4d/9586611/aa65573ebd99/IANN_A_2131326_F0001_C.jpg

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