在非手术治疗近接骨骨折的结果的社会决定因素
Shaun Kai Kiat Chua1, Qian Ying Soh1, Chien Joo Lim2
1Nanyang Technological University, Lee Kong Chian School of Medicine, Singapore, Singapore.
JSES international
|September 18, 2023
概括
社会独立性,包括就业和生活在辅助护理之外,与近腰骨折 (PHFs) 的更好的恢复有关. 有家庭工的患者报告了更糟糕的结果,强调了社会因素对肌肉骨健康的重要性.
科学领域:
- 整形外科和肌肉骨健康
- 健康的社会决定因素
- 患者报告的结果
背景情况:
- 靠近骨骨折 (PHFs) 很常见,特别是在老年人中,并且通常非手术治疗.
- 传统的生物医学因素无法预测PHF后的功能恢复.
- 心理因素是公认的,但社会因素对康复的影响仍未得到充分研究.
研究的目的:
- 调查社会因素与患者报告的结果 (舒适度和能力) 在PHF非手术治疗后6个月和1年的关联.
主要方法:
- 171名非手术治疗的PHF患者完成了基线社会人口统计测量.
- 在6个月和12个月后,使用牛津肩膀评分 (OSS),手臂,肩膀和手的快速残疾 (QuickDASH) 和EuroQol-5维度 (EQ5D) 评估了功能结果.
- 线性回归模型分析了社会因素和结果之间的关系,控制年龄,骨折严重程度,并发症和功能状态.
主要成果:
- 较低的能力 (更高的QuickDASH) 与失业和拥有家务工人有关.
- 更大的肩部不适 (较低的OSS) 和更差的生活质量 (较低的EQ5D) 与拥有家庭工或生活在辅助护理机构有关.
- 生活在辅助护理设施中与肩膀功能和整体生活质量有显著的负面关联.
结论:
- 通过就业地位和生活安排 (没有家庭佣工,生活在护理设施之外) 表示的社会独立性与PHF的更好的恢复有关.
- 这些发现强调了社会决定因素对肌肉骨健康结果的重大影响.
- 建议将社会因素纳入评估和制定PHF恢复护理策略.
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