Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Physical Therapy Lansingerland, Lansingerland, the Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Center for Hand Therapy, Xpert Handtherapie, Utrecht, the Netherlands.
Arch Phys Med Rehabil. 2024 Feb;105(2):314-325. doi: 10.1016/j.apmr.2023.08.003. Epub 2023 Aug 19.
To investigate the association of sociodemographic, clinical, and mindset characteristics on outcomes measured with a patient-specific patient-reported outcome measure (PROM); the Patient Specific Functional Scale (PSFS). Secondly, we examined whether these factors differ when a fixed-item PROM, the Michigan Hand Outcome Questionnaire (MHQ), is used as an outcome.
Cohort study, using the aforementioned groups of factors in a hierarchical linear regression.
Twenty-six clinics for hand and wrist conditions in the Netherlands.
Two samples of patients with various hand and wrist conditions and treatments: n=7111 (PSFS) and n=5872 (MHQ).
NA.
The PSFS and MHQ at 3 months.
The PSFS exhibited greater between-subject variability in baseline, follow-up, and change scores than the MHQ. Better PSFS outcomes were associated with: no involvement in litigation (β[95% confidence interval=-0.40[-0.54;-0.25]), better treatment expectations (0.09[0.06;0.13]), light workload (0.08[0.03;0.14]), not smoking (-0.07[-0.13;-0.01]), men sex (0.07[0.02;0.12]), better quality of life (0.07[0.05;0.10]), moderate workload (0.06[0.00;0.13]), better hand satisfaction (0.05[0.02; 0.07]), less concern (-0.05[-0.08;-0.02]), less pain at rest (-0.04[-0.08;-0.00]), younger age (-0.04[-0.07;-0.01]), better comprehensibility (0.03[0.01;0.06]), better timeline perception (-0.03[-0.06;-0.01]), and better control (-0.02[-0.04;-0.00]). The MHQ model was highly similar but showed a higher R than the PSFS model (0.41 vs 0.15), largely due to the R of the baseline scores (0.23 for MHQ vs 0.01 for PSFS).
Health care professionals can improve personalized activity limitations by addressing treatment expectations and illness perceptions, which affect PSFS outcomes. Similar factors affect the MHQ, but the baseline MHQ score has a stronger association with the outcome score than the PSFS. While the PSFS is better for individual patient evaluation, we found that it is difficult to explain PSFS outcomes based on baseline characteristics compared with the MHQ. Using both patient-specific and fixed-item instruments helps health care professionals develop personalized treatment plans that meet individual needs and goals.
研究社会人口统计学、临床和思维模式特征与特定于患者的患者报告结局测量（PROM）；患者特定功能量表（PSFS）测量结果之间的关系。其次，我们检查了当使用固定项目 PROM（密歇根手部结果问卷（MHQ））作为结局时，这些因素是否存在差异。
使用上述因素组的队列研究，采用分层线性回归。
荷兰 26 家手和腕部疾病诊所。
接受各种手部和腕部疾病治疗的两组患者：n=7111（PSFS）和 n=5872（MHQ）。
无。
PSFS 和 MHQ 在 3 个月时的情况。
PSFS 在基线、随访和变化评分方面表现出更大的个体间变异性，而 MHQ 则更小。更好的 PSFS 结果与以下因素相关：无诉讼参与（β[95%置信区间=-0.40[-0.54;-0.25]）、更好的治疗预期（0.09[0.06;0.13]）、低工作量（0.08[0.03;0.14]）、不吸烟（-0.07[-0.13;-0.01]）、男性（0.07[0.02;0.12]）、更好的生活质量（0.07[0.05;0.10]）、中等工作量（0.06[0.00;0.13]）、更好的手部满意度（0.05[0.02;0.07]）、更少的担忧（-0.05[-0.08;-0.02]）、更少的静息疼痛（-0.04[-0.08;-0.00]）、更年轻的年龄（-0.04[-0.07;-0.01]）、更好的可理解性（0.03[0.01;0.06]）、更好的时间感知（-0.03[-0.06;-0.01]）和更好的控制（0.02[-0.04;-0.00]）。MHQ 模型非常相似，但与 PSFS 模型相比，其 R 值更高（0.41 对 0.15），这主要是由于基线分数的 R 值（MHQ 为 0.23，PSFS 为 0.01）。
医疗保健专业人员可以通过解决治疗预期和疾病认知来改善个性化的活动受限，这些因素会影响 PSFS 的结果。类似的因素会影响 MHQ，但与 PSFS 相比，MHQ 的基线得分与结局得分的关联更强。虽然 PSFS 更适合个别患者的评估，但我们发现与 MHQ 相比，根据基线特征很难解释 PSFS 结果。使用特定于患者和固定项目的工具可以帮助医疗保健专业人员制定满足个人需求和目标的个性化治疗计划。
