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三种不同方法在颞下颌关节紊乱触诊性能中的性别变异性:一项实验研究。

Gender variability in palpation performance for temporomandibular disorders with three different methods: An experimental study.

机构信息

Department of Odontology, Orofacial Pain and Jaw Function, Faculty of Medicine, Umeå University, Umeå, Sweden.

Umeå Centre for Gender Studies, Umeå University, Umeå, Sweden.

出版信息

Eur J Oral Sci. 2024 Dec;132(6):e13026. doi: 10.1111/eos.13026. Epub 2024 Nov 14.

Abstract

Gender differences in pain reporting and prevalence have been demonstrated. As gender of examiner also affects reporting of pain on palpation, the aim of this study was to evaluate the effects of examiner gender on palpation performance using three different palpation methods. Examiners of both genders were instructed on the correct technique for each palpation method by either a female or male instructor. The target was to achieve a pressure of 100 kPa, corresponding to the 1 kg of force for muscle palpation described in the diagnostic criteria for temporomandibular disorders (DC/TMD). All examiners performed traditional palpation with the index finger, palpation with a palpometer, and a novel bimanual palpation with visual feedback, in a randomized order. The examiner's gender, and its interaction with the gender of the instructor did not significantly affect magnitude, accuracy, or precision of the pressure applied. The method of palpation was the only factor that significantly impacted all metrics. The palpometer achieved the lowest palpation magnitude (mean pressure applied = 113.7  kPa, 95% CI: 109.8-117.6), the highest accuracy (absolute difference = 15.7  kPa, 95% CI: 12.3-19.1), and the highest precision (mean coefficient of variation = 6.8, 95% CI: 6.0-7.6), followed by bimanual palpation and traditional palpation. The results suggest that gender differences in pain reporting in patients are not likely to be a result of the technical aspects associated with the gender of the examiner. Instead, these differences may be attributed to other factors, such as sociocultural influences.

摘要

性别差异在疼痛报告和发生率中已有体现。由于检查者的性别也会影响触诊时疼痛的报告,因此本研究旨在评估三种不同触诊方法中检查者性别的差异对触诊表现的影响。男、女检查者均由女性或男性教员指导每种触诊方法的正确技术。目标是达到 100kPa 的压力,相当于颞下颌关节紊乱诊断标准(DC/TMD)中描述的肌肉触诊 1 公斤力。所有检查者均以随机顺序依次进行传统触诊(食指触诊)、触诊计触诊和新的带有视觉反馈的双手触诊。检查者的性别及其与教员性别的相互作用并未显著影响所施加压力的大小、准确性或精度。触诊方法是唯一显著影响所有指标的因素。触诊计的触诊幅度最小(平均施加压力为 113.7kPa,95%置信区间:109.8-117.6),准确性最高(绝对差值为 15.7kPa,95%置信区间:12.3-19.1),精度最高(平均变异系数为 6.8,95%置信区间:6.0-7.6),其次是双手触诊和传统触诊。结果表明,患者疼痛报告中的性别差异不太可能是与检查者性别相关的技术方面的结果。相反,这些差异可能归因于其他因素,例如社会文化影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caa0/11602442/5fa2b6b5a1dc/EOS-132-e13026-g002.jpg

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