慢性腰背和膝关节疼痛患者的赋权及健康相关生活质量：初级保健中的横断面研究。

Patient enablement and health-related quality of life for patients with chronic back and knee pain: a cross-sectional study in primary care.

机构信息

Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.

Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.

出版信息

Br J Gen Pract. 2023 Oct 26;73(736):e867-e875. doi: 10.3399/BJGP.2022.0546. Print 2023 Nov.

DOI:10.3399/BJGP.2022.0546

PMID:37845085

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10587904/

Abstract

BACKGROUND

Chronic back and knee pain impairs health- related quality of life (HRQoL) and patient enablement can improve HRQoL.

AIM

To determine whether enablement was a moderator of the effect of chronic back and knee pain on HRQoL.

DESIGN AND SETTING

A cross-sectional study of Chinese patients with chronic back and knee problems in public primary care clinics in Hong Kong.

METHOD

Each participant completed the Chinese Patient Enablement Instrument-2 (PEI-2), the Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Pain Rating Scale (PRS). Multivariable regression examined the effects of PRS score and PEI-2 score on WOMAC total score. A moderation regression model and simple slope analysis were used to evaluate whether the interaction between enablement (PEI-2) and pain (PRS) had a significant effect on HRQoL (WOMAC).

RESULTS

Valid patient-reported outcome data from 1306 participants were analysed. PRS score was associated with WOMAC total score (β = 0.326, <0.001), whereas PEI-2 score was associated inversely with WOMAC total score (β = -0.260, <0.001) and PRS score. The effect of the interaction between PRS and PEI-2 (PRS × PEI-2) scores on WOMAC total score was significant (β = -0.191, <0.001) suggesting PEI-2 was a moderator. Simple slope analyses showed that the relationship between PRS and WOMAC was stronger for participants with a low level of PEI-2 (gradient 3.056) than for those with a high level of PEI-2 (gradient 1.746).

CONCLUSION

Patient enablement moderated the impact of pain on HRQoL. A higher level of enablement can lessen impairment in HRQoL associated with chronic back and knee pain.

摘要

背景

慢性腰背和膝痛会损害健康相关生活质量（HRQoL），而患者赋权可以改善 HRQoL。

目的

确定赋权是否是慢性腰背和膝痛对 HRQoL 影响的调节因素。

设计和设置

一项在香港公立基层医疗诊所中患有慢性腰背和膝部问题的中国患者的横断面研究。

方法

每位参与者都完成了中文版患者赋权量表-2（PEI-2）、中文版西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和疼痛评分量表（PRS）。多变量回归分析了 PRS 评分和 PEI-2 评分对 WOMAC 总分的影响。采用调节回归模型和简单斜率分析，评估赋权（PEI-2）和疼痛（PRS）之间的相互作用对 HRQoL（WOMAC）是否有显著影响。

结果

对 1306 名参与者的有效患者报告结局数据进行了分析。PRS 评分与 WOMAC 总分相关（β=0.326，<0.001），而 PEI-2 评分与 WOMAC 总分呈负相关（β=-0.260，<0.001）和 PRS 评分。PRS 和 PEI-2（PRS×PEI-2）评分之间相互作用的效应与 WOMAC 总分显著相关（β=-0.191，<0.001），表明 PEI-2 是一个调节因素。简单斜率分析显示，对于 PEI-2 水平较低的参与者，PRS 与 WOMAC 的关系更强（梯度 3.056），而对于 PEI-2 水平较高的参与者，这种关系较弱（梯度 1.746）。