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Long-term changes in pain and function in patients with thumb base osteoarthritis receiving brief information, occupational therapy and/or surgery. 接受简短信息、职业疗法和/或手术治疗的拇指基部骨关节炎患者疼痛和功能的长期变化。
IF 1.3 Q2 Health Professions Pub Date : 2024-04-17 DOI: 10.1002/msc.1883
A. Tveter, N. Østerås, R. Nossum, R. E. Eide, Å. Klokkeide, K. H. Matre, Monika Olsen, I. Kjeken
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引用次数: 0
A narrative synthesis of the effectiveness and acceptability of musculoskeletal first contact physiotherapy practitioner roles in primary care. 关于基层医疗机构中肌肉骨骼第一接触理疗从业人员角色的有效性和可接受性的叙述性综述。
IF 1.3 Q2 Health Professions Pub Date : 2024-04-15 DOI: 10.1002/msc.1875
G. Bicker, T. Hadley-Barrows, Andrew Saunders, Hilary Mairs, K. Stevenson
BACKGROUNDMusculoskeletal (MSK) First Contact Practitioners (FCP), diagnostic clinicians with expertise in the assessment and management of undifferentiated MSK conditions in primary care have been widely employed in the United Kingdom since 2020. The role aims to bring specialist clinical knowledge to patients at the first point of contact and reduce the burden on existing primary care services. Since the national adoption of the role, little has been published to support the effectiveness or acceptability of the role. This narrative synthesis review aims to highlight and summarise the current body of evidence.METHODOLOGYAn adapted systematic review was carried out to inform thematic reporting and narrative synthesis, under the sub-themes of clinical outcomes, patient satisfaction, acceptability and cost analysis.RESULTSEight publications were included in the review, reporting improvements in clinical outcomes in patients seen by MSK FCP, patient satisfaction and general acceptability of the role. However, all data were collected from observational studies and qualitative sources, some of which were found to be of low methodological quality.CONCLUSIONAlthough the review identified consistent positivity relating to effectiveness, satisfaction and acceptability across the reviewed publications, conclusions are limited due to the relatively recent introduction of the FCP role leading to limited availability of relevant publications.
背景 肌肉骨骼科(MSK)首诊医师(FCP)是具有评估和管理初级医疗中未分化的肌肉骨骼科疾病专业知识的诊断临床医师,自 2020 年以来已在英国广泛使用。这一角色旨在为患者提供第一接触点的专业临床知识,减轻现有初级医疗服务的负担。自该角色在全国范围内采用以来,几乎没有发表任何文章来支持该角色的有效性或可接受性。本综述旨在强调和总结当前的证据。方法 在临床结果、患者满意度、可接受性和成本分析等子主题下,进行了改编的系统综述,为专题报告和综述提供信息。结论尽管综述发现所审查的出版物在有效性、满意度和可接受性方面一致积极,但由于 FCP 角色的引入相对较晚,导致相关出版物有限,因此得出的结论有限。
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引用次数: 0
The value of having multidisciplinary input in early arthritis clinics. 早期关节炎门诊多学科参与的价值。
IF 1.3 Q2 Health Professions Pub Date : 2024-04-12 DOI: 10.1002/msc.1880
Sharon Petford, Yunzheng Jiao, Ravinder Sandhu
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引用次数: 0
Client and clinician perspectives about a virtual education and exercise chronic disease management programme for people with hip and knee osteoarthritis. 客户和临床医生对针对髋关节和膝关节骨关节炎患者的虚拟教育和运动慢性病管理计划的看法。
IF 1.3 Q2 Health Professions Pub Date : 2024-04-08 DOI: 10.1002/msc.1881
J. Van Damme, V. D. Dal Bello-Haas, Patricia Strachan, Ayse Kuspinar, M. Kalu, Mashal Zaide
INTRODUCTIONOsteoarthritis (OA) is one of the most prevalent chronic conditions in Canada. Despite the established benefits of non-pharmacological management (education, exercise) for people with OA, many do not receive treatment, resulting in pain, decreased physical function, and poorer quality of life. Virtual programme options grew significantly during the recent pandemic and may provide longer-term opportunities for increased uptake by reaching individuals otherwise unable to participate. This study explored the experiences and perspectives of clients participating in and clinicians providing the Good Life with osteoArthritis: Denmark (GLA:DTM) Canada remote programme.METHODSThis qualitative descriptive study recruited 10 clients with hip and/or knee OA and 11 clinicians across Canada using purposive sampling. An online pre-interview survey was completed, and individual interviews were conducted, audio-recorded, transcribed verbatim and analysed independently by two researchers using inductive thematic analysis. Coding and analyses were initially conducted separately by group and then compared and combined.RESULTSFour overarching themes (and 11 subthemes) were identified: (1) Expected and unexpected benefits of virtual programs; (2) Drawbacks to virtual programs; (3) Programme delivery in a virtual world; (4) Shifting and non-shifting perspectives. Although initially sceptical, after completion of the programme, clients were in favour of virtual delivery with many benefits described. Clinicians' perspectives varied about feedback aimed to correct client movement patterns.CONCLUSIONSClients and clinicians identified important experiential and procedural elements for virtual chronic disease management programs that include education and exercise. Additional work is needed to understand if the GLA:DTM remote outcomes are equivalent to the in-person programme.
简介骨关节炎(OA)是加拿大最常见的慢性疾病之一。尽管非药物治疗(教育、锻炼)对 OA 患者有公认的益处,但许多人并没有接受治疗,结果导致疼痛、身体功能下降和生活质量降低。在最近的大流行病中,虚拟计划的选择大幅增加,并可能通过接触到原本无法参与的人,为增加吸收提供长期机会。本研究探讨了参与 "骨关节炎患者的美好生活 "的客户和提供该项目临床医生的经验和观点:方法这项定性描述性研究通过有目的的抽样,在加拿大各地招募了 10 名髋关节和/或膝关节 OA 患者和 11 名临床医生。访谈前完成在线调查,访谈由两名研究人员采用归纳式主题分析法独立进行,并进行录音、逐字记录和分析。最初按小组分别进行编码和分析,然后进行比较和合并。结果确定了四个总体主题(和 11 个次主题):(1) 虚拟项目的预期好处和意外好处;(2) 虚拟项目的缺点;(3) 虚拟世界中的项目实施;(4) 观点的转变和不转变。虽然客户最初对虚拟课程持怀疑态度,但在完成课程后,他们对虚拟课程的许多好处表示赞同。客户和临床医生对旨在纠正客户运动模式的反馈意见看法不一。要了解 GLA:DTM 远程结果是否等同于现场计划,还需要做更多的工作。
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引用次数: 0
Early mobilisation after hip fracture surgery is associated with improved patient outcomes: A systematic review and meta-analysis. 髋部骨折术后早期活动与改善患者预后有关:系统回顾和荟萃分析。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-03-01 DOI: 10.1002/msc.1863
Nikhil Agarwal, Tony Feng, Alasdair Maclullich, Andrew Duckworth, Nicholas Clement

Introduction: The aims of this systematic review and meta-analysis were to determine if after hip fracture surgery (1) early mobilisation is associated with improved clinical outcomes, and if so (2) are benefits directly proportional to how soon after surgery the patient mobilises.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review was conducted using four databases to identify all studies that compared postoperative early mobilisation with delayed mobilisation, in patients after hip fracture surgery. The Critical Appraisal Skills Programme checklist was employed for critical appraisal and evaluation of all studies that met the inclusion criteria.

Results: A total of 13 studies, including 297,435 patients were identified, of which 235,275 patients were mobilised early and 62,160 were mobilised late. Six studies assessed 30-day mortality, of which two also investigated 30-day complication rates. Pooled meta-analysis demonstrated that there were significantly lower 30-day mortality rates (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.31-0.41, p < 0.001) and complication rates (OR 0.43, 95% CI 0.36-0.51, p < 0.001) in patients mobilising early after hip fracture surgery. Five studies investigated length of stay (LOS) and meta-analysis revealed no difference between groups (mean difference -0.57 days, 95% CI -1.89-0.74, p = 0.39).

Conclusion: Early mobilisation in hip fracture patients is associated with a reduction in 30-day mortality and complication rates compared to delayed mobilisation, but no difference in LOS. These findings illustrate that early mobilisation is associated with superior post operative outcomes. However, a direct casual effect remains to be demonstrated, and further work on the factors underlying delayed mobilisation is required.

简介:本系统综述和荟萃分析的目的是确定髋部骨折术后(1)早期活动是否与临床预后的改善有关,如果是,(2)其益处是否与患者术后活动的时间成正比:方法: 我们使用四个数据库进行了系统综述和荟萃分析首选报告项目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)的系统综述,以确定所有对髋部骨折术后患者术后早期活动与延迟活动进行比较的研究。在对所有符合纳入标准的研究进行批判性评估和评价时,采用了批判性评估技能计划核对表:结果:共确定了 13 项研究,包括 297,435 名患者,其中 235,275 名患者接受了早期活动,62,160 名患者接受了晚期活动。六项研究评估了30天的死亡率,其中两项还调查了30天的并发症发生率。汇总荟萃分析表明,30天死亡率明显降低(几率比[OR]0.35,95%置信区间[CI]0.31-0.41,P 结论:髋部骨折患者及早进行康复训练可显著降低死亡率:与延迟移动相比,髋部骨折患者早期移动可降低 30 天死亡率和并发症发生率,但在 LOS 方面没有差异。这些研究结果表明,早期活动与良好的术后效果有关。然而,直接的偶然效应仍有待证实,还需要进一步研究延迟活动的潜在因素。
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引用次数: 0
The SelfSTarT intervention for low back pain patients presenting to first contact physiotherapists: A mixed methods service evaluation. 针对初次接触理疗师的腰痛患者的 SelfSTarT 干预疗法:混合方法服务评估。
IF 1.3 Q2 Health Professions Pub Date : 2024-03-01 DOI: 10.1002/msc.1876
K Stevenson, T Hadley-Barrows, N Evans, L Campbell, J Southam, A Chudyk, D Ellington, B Jeeves, C Jenson, S Kleberg, H Birkinshaw, F Mair, K Dziedzic, G Peat, K P Jordan, D Yu, J Bailey, A Braybooke, C D Mallen, Jonathan C Hill

Introduction: Globally, back pain is the leading cause of years of disability. In the United Kingdom, over 20 million people live with musculoskeletal (MSK) pain, with low back pain being one of the most common causes. National strategies promote self-management and the use of digital technologies to empower populations.

Aims: To evaluate the uptake and impact of providing the SelfSTart approach (STarT Back and SelfBACK App) when delivered by a First Contact Physiotherapist (FCP) to people presenting with low back pain in primary care.

Methods: Patients presenting with a new episode of low back pain underwent routine assessment and completion of a STarT Back questionnaire. Patients with low/medium scores were offered the SelfBACK App. A control population was provided by the MIDAS-GP study. Patient Experience, outcome measures, healthcare utilisation and retention were captured through the app and clinical systems (EMIS). Interviews with five FCPs explored the experiences of using the SelfSTart approach.

Results: SelfSTarT was taken up by almost half (48%) of those to whom it was offered. Compared to MIDAS-GP, users were more likely to be younger, male, in work, and with higher health literacy. SelfSTarT users reported significant improved experiences relating to receiving an agreed care plan and receiving sufficient information. There were no significant differences in treatments offered. FCPs were positive about the app and felt it had value but wanted feedback on patient progress. They recognised that a digital solution would not be suitable for all.

Conclusion: This approach offers an opportunity to empower and support self-management, using robustly evaluated digital technology.

导言:在全球范围内,背痛是导致多年残疾的主要原因。在英国,2000 多万人患有肌肉骨骼(MSK)疼痛,其中腰背痛是最常见的原因之一。国家战略提倡自我管理和使用数字技术来增强民众的能力。目的:评估由第一接触物理治疗师(FCP)向初级保健中出现腰背痛的患者提供 "自我开始 "方法(STarT Back 和 SelfBACK App)的吸收率和影响:新发腰痛患者接受常规评估并填写 STarT Back 问卷。得分低/中等的患者可使用 SelfBACK 应用程序。对照人群由 MIDAS-GP 研究提供。通过应用程序和临床系统(EMIS)采集患者体验、结果测量、医疗保健利用率和保留率。与五位家庭护理中心主任进行了访谈,探讨了使用 SelfSTart 方法的经验:结果:SelfSTarT 被近一半(48%)的用户所接受。与 MIDAS-GP 相比,使用者更可能是年轻人、男性、在职者和健康知识水平较高者。SelfSTarT用户报告称,他们在获得一致同意的护理计划和获得充足信息方面的体验明显改善。在提供的治疗方面没有明显差异。家庭医生对该应用程序持肯定态度,认为它很有价值,但希望能得到病人进展情况的反馈。他们认识到数字解决方案并不适合所有人:这种方法提供了一个机会,利用经过严格评估的数字技术,增强和支持自我管理。
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引用次数: 0
Rotator cuff disorders: An updated survey of current (2023) UK physiotherapy practice. 肩袖疾病:当前(2023 年)英国物理治疗实践的最新调查。
IF 1.3 Q2 Health Professions Pub Date : 2024-03-01 DOI: 10.1002/msc.1872
Maria Moffatt, Stacey Lalande, Natasha Maher, Chris Littlewood

Background: Clinical guidelines recommend treatment by a physiotherapist for people with shoulder pain due to rotator cuff disorder. Despite this recommendation, research evidence supporting the effectiveness of treatment by a physiotherapist is uncertain. While developing a randomised controlled trial to test the effectiveness of treatment by a physiotherapist for people with shoulder pain due to rotator cuff disorders, we first aimed to understand current practice as a basis for defining usual care.

Methods: An online survey was developed based on a clinical vignette used in a previous survey exploring physiotherapy practice for people with shoulder pain due to rotator cuff disorder. UK-based physiotherapists were invited to complete the survey via X and email across professional networks.

Results: One Hundred Seventy complete responses were received. 167 (98%) respondents would offer advice/education to patients with shoulder rotator cuff disorders; 146 (86%) would use isotonic exercise (including concentric/eccentric strengthening); 20 (12%) would offer a corticosteroid injection; 7 (4%) would use joint mobilisation. 168/169 (99%) would offer in-person assessment; 115 (68%) expect to deliver treatment over three to four sessions. Fifty percent agreed there is uncertainty about the effectiveness of physiotherapy treatment for patients with shoulder rotator cuff disorders. Seventy six percent agreed that patients with this condition can recover without physiotherapy intervention.

Conclusions: Exercise and advice remain the most common treatments offered by physiotherapists for people with shoulder pain due to rotator cuff disorder. Corticosteroid injections are infrequently considered. Uncertainty about the effectiveness of treatment by a physiotherapist for shoulder pain due to rotator cuff disorder is evident.

背景:临床指南建议由物理治疗师为因肩袖疾病导致肩部疼痛的患者提供治疗。尽管有此建议,但支持物理治疗师治疗效果的研究证据并不确定。在制定随机对照试验以检验物理治疗师对肩袖疾病引起的肩痛患者进行治疗的有效性时,我们首先要了解目前的做法,以此作为界定常规护理的基础:方法:我们根据之前一项调查中使用的临床小插图制作了一份在线调查,该调查旨在探讨物理治疗师对肩袖疾病引起的肩痛患者的治疗方法。我们邀请英国的物理治疗师通过 X 和电子邮件在专业网络中完成调查:结果:共收到 170 份完整的回复。167名受访者(98%)会为肩袖疾病患者提供建议/教育;146名受访者(86%)会进行等张锻炼(包括同心/同心加强);20名受访者(12%)会进行皮质类固醇注射;7名受访者(4%)会进行关节活动。168/169(99%)人将提供亲临现场的评估;115(68%)人希望通过三到四次治疗来提供治疗。50%的人认为物理治疗对肩袖疾病患者的治疗效果存在不确定性。76%的人认为这种疾病的患者无需物理治疗干预即可康复:运动和建议仍然是物理治疗师为肩袖疾病引起的肩部疼痛患者提供的最常见治疗方法。皮质类固醇注射很少被考虑。物理治疗师对肩袖疾病引起的肩部疼痛的治疗效果存在明显的不确定性。
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引用次数: 0
An exploration of low back pain beliefs held by health care professionals in Northern America. 对美国北部医疗保健专业人员所持腰背痛观念的探讨。
IF 1.3 Q2 Health Professions Pub Date : 2024-03-01 DOI: 10.1002/msc.1877
B Michael Ray, Leah Washington, Bronwyn Lennox Thompson, Kyle Kelleran

Background: Prior research demonstrated that people in the United States and Canada (Northern America) hold predominantly biomedical beliefs about Low back pain (LBP); such beliefs were attributed to healthcare professionals (HCP). Further investigation is needed to understand HCP' LBP beliefs, preferred management strategies, and sources of beliefs.

Methods: Participants were recruited via social media to complete a qualitative cross-sectional online survey. The survey was distributed to assess LBP beliefs in a U.S. and Canadian-based clinician population. Participants answered questions about the cause of LBP, reasons for recurrence or persistence, use of imaging, management strategies, and sources of beliefs. Responses were analysed using an inductive thematic analysis.

Results: One hundred and sixty three participants were included, reporting multiple causes for LBP. However, many references were anchored to biological problems. When psychological variables were mentioned, it typically involved patient blaming. Like prior research studies, minimal attention was given to societal and environmental influences. Management strategies often aligned with guideline care except for the recommendation of inappropriate imaging and a reliance on passive interventions.

Conclusions: These findings align with prior research studies on general population beliefs, demonstrating a preference for biological causes of LBP. Further updates are needed for clinical education, while future studies should seek to assess the translation of clinician beliefs into clinical practice and health system constraints.

背景:先前的研究表明,美国和加拿大(北美洲)的人们对腰背痛(LBP)主要持有生物医学信念;这种信念归因于医疗保健专业人员(HCP)。要了解医护人员的腰背痛信念、偏好的管理策略以及信念的来源,还需要进一步的调查:方法: 通过社交媒体招募参与者,让他们完成一项横断面定性在线调查。该调查旨在评估美国和加拿大临床医生的枸杞多糖症信念。参与者回答了有关枸杞多糖症的病因、复发或持续存在的原因、影像学的使用、管理策略以及信念来源的问题。我们采用归纳式主题分析法对参与者的回答进行了分析:结果:163 名参与者报告了导致腰痛的多种原因。然而,许多人提到的都是生物学问题。当提到心理变量时,通常涉及患者的自责。与之前的研究一样,对社会和环境影响的关注极少。除了推荐不适当的影像学检查和依赖被动干预外,管理策略通常与指南护理一致:结论:这些研究结果与之前关于普通人群观念的研究结果一致,表明人们更倾向于认为腰椎间盘突出症是由生物学原因引起的。临床教育需要进一步更新,而未来的研究则应寻求评估临床医生的观念转化为临床实践和医疗系统制约因素的情况。
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引用次数: 0
Exploring the potential extended role of community pharmacy in the management of osteoarthritis: A multi-methods study with pharmacy staff and other healthcare professionals. 探索社区药房在骨关节炎管理中的潜在扩展作用:与药房工作人员和其他医疗保健专业人员共同开展的一项多方法研究。
IF 1.3 Q2 Health Professions Pub Date : 2024-03-01 DOI: 10.1002/msc.1873
Joanna Simkins, Melanie A Holden, Opeyemi Babatunde, Simon White, Elaine Nicholls, Angela Long, Krysia Dziedzic, Adrian Chudyk, Adam Todd, Christine Walker, Colin Stanford, Elizabeth Cottrell, John Edwards, Emma L Healey, Tania Cork, Christian Mallen, Nicola O'Brien

Introduction: Osteoarthritis is the commonest form of chronic joint pain, which patients often self-manage before seeking healthcare advice. Patients frequently seek advice from community pharmacies, and a recent policy has recommended integrating community pharmacies into long-term condition pathways. This study explored community pharmacy teams' (CPs) and other healthcare professionals' (HCPs) views on community pharmacies providing an extended role for osteoarthritis management, identifying potential barriers and facilitators to this.

Methods: A multi-methods study comprising surveys of CPs and other HCPs, followed by qualitative interviews. Descriptive statistics were used in an exploratory analysis of the survey data. Qualitative data were analysed using reflexive thematic analysis and the identified barriers and facilitators were mapped to the Theoretical Domains Framework.

Result: CPs and other HCPs in the surveys and interviews reported that an extended role for osteoarthritis management could include: a subjective assessment, explaining the joint problem and its treatment, medication management and support for self-care. There was less consensus on diagnosing the problem as OA and completing an objective assessment. A key facilitator was training to deliver the role, whilst barriers were high workload and lack of access to General Practitioner medical records.

Discussion: Acceptable elements of an extended community pharmacy role for osteoarthritis centre around the provision of information, advice on medication and supported self-management.

Conclusion: CPs are well placed to contribute towards evidenced-based osteoarthritis management. Feasibility testing of delivering the extended role is needed and future implementation requires training for CPs and raising public awareness of the extended role.

简介骨关节炎是慢性关节疼痛中最常见的一种,患者在寻求医疗建议之前通常会进行自我管理。患者经常向社区药房寻求建议,最近的一项政策建议将社区药房纳入长期治疗路径。本研究探讨了社区药房团队(CPs)和其他医疗保健专业人员(HCPs)对社区药房为骨关节炎管理提供延伸服务的看法,并确定了潜在的障碍和促进因素:采用多种方法进行研究,包括对 CP 和其他 HCP 进行调查,然后进行定性访谈。在对调查数据进行探索性分析时使用了描述性统计。采用反思性主题分析法对定性数据进行分析,并将确定的障碍和促进因素映射到理论领域框架:结果:在调查和访谈中,CP 和其他 HCP 报告称,骨关节炎管理的扩展角色可包括:主观评估、解释关节问题及其治疗、药物管理和自我护理支持。对于将问题诊断为 OA 和完成客观评估的共识较少。关键的促进因素是提供相关培训,而障碍则是工作量大和无法获得全科医生的医疗记录:讨论:扩展社区药房在骨关节炎方面的作用的可接受要素主要是提供信息、用药建议和支持自我管理:结论:社区药房完全有能力为以证据为基础的骨关节炎管理做出贡献。需要对提供扩展角色进行可行性测试,未来的实施需要对 CPs 进行培训,并提高公众对扩展角色的认识。
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引用次数: 0
"IT's too much to do alone": A mixed-methods exploration of patient experiences implementing emergency department management plans for chronic pain. "一个人做的事情太多了":对急诊科慢性疼痛管理计划实施过程中患者体验的混合方法探索。
IF 1.3 Q2 Health Professions Pub Date : 2024-03-01 DOI: 10.1002/msc.1874
Bernadette Brady, Sheng Min Pang, Sarah Dennis, Lucy Chipchase, Pranee Liamputtong, Matthew Jennings, Elise Tcharkhedian, Toni Andary, Natalie Pavlovic, Marguerite Zind, Paul Middleton, Robert Boland

Objectives: To explore the experiences of socio-culturally diverse community members attempting to manage their chronic pain and enact evidence-based management plans following an index Emergency Department (ED) visit.

Methods: A convergent parallel mixed-methods design with qualitative interviews and descriptive analysis was undertaken in two public hospitals in a multicultural region in Sydney, Australia. Consecutive adults were recruited from culturally and linguistically diverse (CALD: n = 45) or Australian-born (n = 45) backgrounds, who presented to the ED for a chronic neuromusculoskeletal pain condition. Consenting participants were prescribed an individualised chronic pain management plan following examination by a physiotherapist, who collected standardised measures of pain and health literacy. Six months later, participants underwent a structured phone survey regarding their pain status and whether they had actioned management plans. Participants were invited to participate in a semi-structured interview.

Results: Six-month data were available for 82 of 90 participants who attended the ED and consented to the baseline assessment (40 CALD and 42 Australian-born). Participants were 52% females, predominately middle-aged (mean age 54.7 years), with an overall mean symptom duration of 10 years (SD 9.0). At 6 months, there were nine representations by six CALD participants and 23 by nine Australian-born participants. Overall, 52% reported unchanged pain, 24% were worse and 23% improved, with similar action plan progress for CALD (58%) and Australian-born (53%) participants. Pain features and health literacy were similar, irrespective of progress with pain management plans. From 41 participants who consented to phone interviews, three themes emerged to explain their progress with recommendations: 'illness model', 'urgency' and 'control orientation'.

Conclusions: Patients presenting to the ED with chronic pain might be more likely to action discharge recommendations if primary care providers identify patient-specific and contextual barriers to implementation.

目的探讨不同社会文化背景的社区成员在急诊科就诊后试图管理其慢性疼痛并制定循证管理计划的经历:方法: 在澳大利亚悉尼多元文化地区的两家公立医院中,采用并行混合方法设计,进行定性访谈和描述性分析。连续招募了来自不同文化和语言背景(CALD:n = 45)或在澳大利亚出生(n = 45)的成年人,他们因慢性神经肌肉骨骼疼痛到急诊室就诊。获得同意的参与者在接受理疗师检查并收集标准化的疼痛和健康知识测量数据后,将接受个性化的慢性疼痛管理计划。6 个月后,参与者接受了一次结构化电话调查,了解他们的疼痛状况以及是否执行了管理计划。参与者还受邀参加了半结构化访谈:在 90 名到过急诊室并同意接受基线评估的参与者中,有 82 人(40 名 CALD 和 42 名澳大利亚出生者)接受了为期 6 个月的数据采集。参与者中女性占 52%,以中年人为主(平均年龄 54.7 岁),症状持续时间平均为 10 年(标清 9.0)。6 个月时,6 名 CALD 参与者有 9 次陈述,9 名澳大利亚出生的参与者有 23 次陈述。总体而言,52%的人表示疼痛没有改变,24%的人表示疼痛加重,23%的人表示疼痛有所改善,CALD(58%)和澳大利亚出生的参与者(53%)的行动计划进展情况相似。无论疼痛管理计划的进展如何,疼痛特征和健康素养都相似。在 41 位同意接受电话访谈的参与者中,有三个主题可以解释他们在落实建议方面的进展情况:结论:结论:如果初级医疗服务提供者能识别患者的具体情况和实施障碍,慢性疼痛急诊患者可能更有可能执行出院建议。
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引用次数: 0
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