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基层医疗中多模式疼痛康复干预的介绍:一项试点研究。

INTRODUCTION OF A MULTIMODAL PAIN REHABILITATION INTERVENTION IN PRIMARY CARE: A PILOT STUDY.

作者信息

Eklund Katarina, Stålnacke Britt-Marie, Sundberg Annica, Eklund Fredrik, Eklund Michael

机构信息

Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.

Department of Social Services and Health Care in Jakobstad, The Rehabilitation Unit, Jakobstad, Finland.

出版信息

J Rehabil Med Clin Commun. 2023 Feb 27;6:3712. doi: 10.2340/jrmcc.v6.3712. eCollection 2023.

Abstract

OBJECTIVE

To evaluate patient-reported outcome measures in patients with chronic musculoskeletal pain 1 year after participation in a case manager-led multimodal rehabilitation intervention in a Finnish primary care centre. Changes in healthcare utilization (HCU) were also explored.

METHODS

A prospective pilot study with 36 participants. The intervention consisted of screening, multidisciplinary team assessment, a rehabilitation plan and case manager follow-up. Data were collected through questionnaires filled in after the team assessment and 1 year later. HCU data 1 year before and 1 year after team assessment were compared.

RESULTS

At follow-up, satisfaction with vocational situation, self-reported work ability and health-related quality of life (HRQoL) had improved and pain intensity had diminished significantly for all participants. The participants who reduced their HCU improved their activity level and HRQoL. Early intervention by a psychologist and mental health nurse was distinctive for the participants who reduced HCU at follow-up.

CONCLUSION

The findings demonstrate the importance of early biopsychosocial management of patients with chronic pain in primary care. Identification of psychological risk factors at an early stage may lead to better psychosocial wellbeing, improve coping strategy and reduce HCU. A case manager may free up other resources and thereby contribute to cost savings.

摘要

目的

评估芬兰一家初级保健中心参与由个案管理员主导的多模式康复干预1年后慢性肌肉骨骼疼痛患者的患者报告结局指标。还探讨了医疗保健利用率(HCU)的变化。

方法

一项针对36名参与者的前瞻性试点研究。干预措施包括筛查、多学科团队评估、康复计划和个案管理员随访。数据通过团队评估后及1年后填写的问卷收集。比较团队评估前1年和团队评估后1年的HCU数据。

结果

随访时,所有参与者对职业状况的满意度、自我报告的工作能力和健康相关生活质量(HRQoL)均有所改善,疼痛强度显著降低。HCU降低的参与者其活动水平和HRQoL得到改善。心理学家和心理健康护士的早期干预对于随访时HCU降低的参与者来说较为独特。

结论

研究结果表明在初级保健中对慢性疼痛患者进行早期生物心理社会管理的重要性。早期识别心理风险因素可能会带来更好的心理社会幸福感,改善应对策略并降低HCU。个案管理员可以腾出其他资源,从而有助于节省成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4db2/9983332/966466d22f62/JRMCC-6-3712-g001.jpg

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