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Updated: Feb 13, 2026

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Published on: June 21, 2010

患者は何を望んでいるのか? 多様な世界における成果測定法

Ashley Titan¹, Elspeth Hill², Camille Brenac^1,3

¹Stanford University Medical Center, Department of Surgery, Division of Plastic Surgery, Stanford, CA.

Journal of hand surgery global online

|February 12, 2026

まとめ

手術における患者報告結果測定法 (PROM) は,患者の優先順位が異なることを示しています. 患者特異機能スケール (PSFS) のような,文化に敏感な,オープンエンドのツールは,標準化された,閉鎖的なPROMよりも,個々の目標をよりよく捉えます.

科学分野:

整形外科とスポーツ医学
患者によって報告された結果の尺度
グローバル・ヘルスグローバル・ヘルス

背景:

伝統的な手術の結果の定量化は,運動範囲やピンチの強さなどの客観的な尺度に依存していました.
患者中心のケアは,多数の病理学特異的な,閉じた終末の患者報告結果測定法 (PROM) の開発につながりました.
既存のPROMは,しばしば欧米の起源であり,グローバルな患者集団の多様な価値と優先順位を完全に捉えることができない可能性があります.

研究の目的:

手の病状に関する一般的な文化における患者体験と治療目標の幅を評価する.
患者特異機能スケール (PSFS) の開いたPROMの有用性を評価し,患者によって報告されたさまざまな機能的影響を把握する.
カーパルトンネル症候群 (CTS) とトリガーフィンガー (TF) の標準化された閉塞型PROMとPSFSの包括性を比較する.

主な方法:

カーパルトンネル症候群 (CTS) とトリガー指 (TF) と診断された患者を対象とした多機関,国際的な研究.
患者によって報告された機能的困難と目標は,オープンエンドの患者特異機能スケール (PSFS) を使用して収集されました.
テンプレート分析を用いた質的データ分析は,3つの大陸と5つの国から225件のPSFS回答に実施されました.

主要な成果:

患者の反応は,CTSとTFの多様な機能的影響を明らかにし,国際機能分類を用いて分類された.
機能ドメインの表現の有意な変動は,異なる国々で観察され,文化的影響を示しています.
標準化されたPROM (QuickDASH,Boston Carpal Tunnel Score,PROMIS) は,PSFSを通じて患者によって特定された国別優先順位を完全に捉えることができませんでした.

結論:

手の機能に関する患者の優先順位は多様で,文化的文脈によって大きく影響を受けます.
PSFSのようなオープンな評価ツールは,個々の患者の目標と経験の豊かさを把握するために不可欠です.
標準化された,閉ざされたPROMは,異文化間の違いやより幅広い患者の懸念を無視し,正確な結果評価を妨げることがあります.

キーワード:

カーパル・トンネルとは文化間の多様性文化間の多様性手の手術の手術の手術手術の手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術手術患者によって報告されたアウトカムを測定します.トリガーの指が指で動いている.

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