Türp J C, Kowalski C J, Stohler C S
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA.
J Orofac Pain. 1998 Winter;12(1):61-6.
Knowledge about the different kinds of treatment provided to patients with nonmalignant musculoskeletal facial pain is limited. The present study was based on 206 consecutive patients who were referred to a university-based tertiary care clinic for the diagnosis and management of persistent facial pain. Its purpose was to get information about the number and specialty of providers consulted by patients prior to their referral, and to follow the underlying treatment-seeking patterns. The results showed that on average 4.88 providers from 44 different categories were consulted. A general dentist or a dental specialist was seen by about 70% of patients. For patients whose first provider was a dentist, the most likely subsequent provider was another dentist. Conversely, if the first provider was a physician, chances were greater that the subsequent provider was a physician rather than a dentist. Among the nondental therapies patients received, physical therapy was chosen most frequently (42.2%). More than 60% of patients had at least one nondental treatment; however, the majority of these patients experienced two or more different types of such therapy (e.g., chiropractic, osteopathic, relaxation training). Patients' satisfaction with care and treatment was moderate, since only 18.5% of the patients were very satisfied, while 27.7% were dissatisfied or very dissatisfied. The present findings, which corroborate a recent study from the Kansas City, Missouri, region, indicate that patients with persistent facial pain see a large number of different providers, and that nonmedical/nondental treatment approaches are common. The moderate satisfaction experienced with any of the therapies points out that much needs to be done before this patient population is served satisfactorily.
关于为非恶性肌肉骨骼性面部疼痛患者提供的不同治疗方式的知识有限。本研究基于206例连续转诊至一所大学附属三级护理诊所以诊断和管理持续性面部疼痛的患者。其目的是获取患者转诊前咨询的医疗服务提供者的数量和专业信息，并追踪潜在的就医模式。结果显示，患者平均咨询了来自44个不同类别的4.88名医疗服务提供者。约70%的患者看过普通牙医或牙科专科医生。对于首位医疗服务提供者是牙医的患者，后续最可能咨询的是另一位牙医。相反，如果首位医疗服务提供者是内科医生，那么后续咨询内科医生而非牙医的可能性更大。在患者接受的非牙科治疗中，物理治疗是最常被选择的（42.2%）。超过60%的患者至少接受过一种非牙科治疗；然而，这些患者中的大多数接受过两种或更多不同类型的此类治疗（如脊椎按摩治疗、整骨疗法、放松训练）。患者对护理和治疗的满意度一般，因为只有18.5%的患者非常满意，而27.7%的患者不满意或非常不满意。本研究结果证实了密苏里州堪萨斯城地区最近的一项研究，表明持续性面部疼痛患者会咨询大量不同的医疗服务提供者，并且非医学/非牙科治疗方法很常见。对任何一种治疗的中等满意度表明，在为这一患者群体提供令人满意的服务之前，还有很多工作要做。
