Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University.
Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University.
J Rehabil Med. 2023 Jan 31;55:jrm00371. doi: 10.2340/jrm.v55.3424.
To investigate patients' expectations, met/unmet expectations and satisfaction with intrathecal baclofen treatment in relation to effect on spasticity, pain intensity, sleep quality, occupational performance, well-being and self-efficacy.
A prospective longitudinal study with follow-up at 1 year.
Consecutive patients, age ≥ 18 years with a disabling spasticity of cerebral or spinal origin selected for intrathecal baclofen treatment at 2 university hospitals in Sweden were included. From August 2016 to June 2019, 35 patients began intrathecal baclofen treatment; 29 patients were included and completed the study.
Baseline and 1-year follow-up included assessment of spasticity by physiotherapists, a semi-structured interview regarding occupational performance using the Canadian Occupational Performance Measure and a questionnaire.
Overall satisfaction with treatment and satisfaction with occupational performance were reported as moderate. Important variables that explained satisfaction with occupational performance were improvements in performance, expectations and performance before treatment. Patients had higher expectations compared with the 1-year outcomes regarding occupational performance, spasticity, pain intensity and sleep quality, although improvements were reported.
A thorough discussion of goal setting with intrathecal baclofen treatment before implantation is necessary to give patients individual and realistic expectations.
调查与鞘内巴氯芬治疗的效果（对痉挛、疼痛强度、睡眠质量、职业表现、幸福感和自我效能的影响）相关的患者期望、期望满足情况和满意度。
前瞻性纵向研究，随访时间为 1 年。
连续选择在瑞典 2 所大学医院接受鞘内巴氯芬治疗的、年龄≥18 岁、有因脑或脊髓起源导致的致残性痉挛的患者。2016 年 8 月至 2019 年 6 月，35 例患者开始接受鞘内巴氯芬治疗；29 例患者入组并完成了研究。
基线和 1 年随访时，理疗师评估痉挛情况，采用加拿大职业表现量表进行半结构化访谈评估职业表现，并采用问卷评估。
治疗总体满意度和职业表现满意度报告为中等。能够解释职业表现满意度的重要变量是治疗前后的表现改善、期望和表现。尽管患者报告了改善，但与 1 年结果相比，他们对职业表现、痉挛、疼痛强度和睡眠质量的期望更高。
在植入前需要对鞘内巴氯芬治疗进行目标设定的充分讨论，以给患者提供个性化和现实的期望。
