功能性患者报告的结果措施是否反映了部或膝关节关节置换术后患者最关心的活动?
Motahareh Karimijashni1,2, Marie Westby3, Paul E Beaulé4,5
1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Clinical orthopaedics and related research
|November 26, 2025
概括
目前的关节和膝关节置换患者患者报告结果测量 (PROM) 无法充分捕捉患者重要的功能活动,特别是在晚期康复过程中. 未来的PROM需要患者的意见,以便更好地评估治疗的有效性.
科学领域:
- 整形外科手术 整形外科手术
- 康复医学 康复医学 康复医学
- 患者报告的结果措施 (PROMs)
背景情况:
- 在结果评估中,越来越强调以患者为中心的护理.
- 我们对当前部/膝关节关节整形手术的功能性PROM与患者观点的一致程度的理解有限.
- 需要评估患者手术后关键的功能活动.
研究的目的:
- 在部或膝关节关节整形术后的2,6,13,26周评估现有PROM对患者重要的功能活动的覆盖.
- 确定PROM不充分覆盖或错过的功能活动.
- 确定哪些不重要的活动包含在当前的PROM中.
主要方法:
- 对47个PROM进行分析,评估功能关键活动覆盖范围和差距.
- 根据953名接受部或膝关节关节整形手术的患者,确定了22项关键活动.
- 定义"关键活动"对≥75%的患者来说是重要的,对≥15%的患者来说是困难的.
主要成果:
- 没有PROM完全覆盖了所有关键活动;随着时间的推移,外科手术后的覆盖率显著下降.
- 膝盖损伤和骨关节炎结局得分 (KOOS) 和部残疾和骨关节炎结局得分 (HOOS) 显示,各自的PROM的覆盖范围最广泛.
- 几个关键活动 (例如,家务,楼梯) 被不充分覆盖,五个根本没有覆盖;所有PROM都包括非关键活动.
结论:
- 有限的PROM综合性可能导致不准确的治疗疗效评估,并影响医疗保健服务利用率.
- 未来用于部和膝关节关节整形的PROM开发必须涉及患者,以确保充分覆盖基本功能活动.
- 根据康复阶段选择PROM并平衡综合性与患者负担对于有效的临床决策至关重要.
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