Udén A
Department of Orthopaedics, Malmö General Hospital, Sweden.
Qual Life Res. 1994 Dec;3 Suppl 1:S33-4. doi: 10.1007/BF00433373.
In the city of Malmö, Sweden, a project was started to improve the rehabilitation of patients with back pain. Among 532 patients with back pain who were on sick leave for an average of 98 days the year preceding the consultation, very few specific diagnoses were made in spite of a thorough clinical and radiological examination. Only five of the patients were cured by surgery. During the same period 103 patients were operated on for disc herniation or nerve root stenosis at the Orthopaedic Department at Malmö General Hospital. Thus the routines for somatic diagnosis of the medical service in Malmö are adequate and an improvement would have very little effect on the expenditures for sick leave and early retirement. As suggested in this paper social and psychological factors are of greater importance in the rehabilitation and we should focus less on the physical problems of the patient.
在瑞典马尔默市，启动了一个旨在改善背痛患者康复情况的项目。在咨询前一年平均休病假98天的532名背痛患者中，尽管进行了全面的临床和放射学检查，确诊的具体病症却寥寥无几。只有5名患者通过手术治愈。同一时期，马尔默综合医院骨科为103名椎间盘突出或神经根狭窄患者实施了手术。因此，马尔默医疗服务机构的躯体诊断流程是足够的，改进对病假和提前退休支出的影响将微乎其微。正如本文所建议的，社会和心理因素在康复过程中更为重要，我们应该减少对患者身体问题的关注。
