The impact of personal functional goal achievement on patient satisfaction with progress one year following completion of a functional restoration program for chronic disabling spinal disorders.
The impact of personal functional goal achievement on patient satisfaction with progress one year following completion of a functional restoration program for chronic disabling spinal disorders.
复制标题
DOI：
10.1097/brs.0b013e3181a9e640
复制
发表时间：
2009-12-01
期刊：
影响因子：
3
通讯作者：
Ossen ES
中科院分区：
文献类型：
--
作者：
Hazard RG;Spratt KF;McDonough CM;Carayannopoulos AG;Olson CM;Reeves V;Sperry ML;Ossen ES
这项前瞻性队列研究调查了慢性致残性脊柱疾病（CDSD）患者的个人目标实现情况和对进展的满意度。本研究探讨了CDSD患者在完成功能恢复计划（FRP）至少1年后对进展的满意度与几种替代结局指标之间的关系。CDSD的治疗结果指标通常包括疼痛、体能和功能/职业状态。这些因素之间的相关性较弱，可能无法反映个体患者的观点和优先事项。入组FRP后，记录患者的治疗前功能、工作和娱乐目标。治疗前和治疗结束时的临床指标包括：疼痛、残疾、恐惧回避、举重、躯干灵活性和跑步机耐力。至少1年后，程序完成调查邮寄给连续FRP毕业生。如果可能，通过电话对无应答者进行调查。调查包括每位患者的个人治疗前目标，并评估平均疼痛，SF-36身体功能和满意度“与您的疼痛问题取得的进展”。每位患者指出了每个个人目标的重要性和成就水平，并将这些分数整合以产生目标成就分数（GAS）。使用线性回归来检验1年进展满意度与以下变量之间的关系：临床指标的基线至项目结束变化，以及1年疼痛、身体功能和GAS。在106份邮寄的调查中，89份（84%）被退回，86份（81%）有完整的数据可供分析。项目前后的临床指标均与满意度无显著相关性（总体R2=0.013，p<0.74）。相比之下，年终平均疼痛（R2=0.28），身体功能（R2=0.29）和GAS（R2=0.29）均与满意度显著相关（p<0.0001），合并R2=0.43，p<0.0001。在这些变量中，GAS对满意度的贡献最高。对于CDSD患者完成康复后一年，与更传统的结果相比，目标达成评分对患者满意度的贡献最大。目标实现可能是一个有价值的以患者为中心的治疗结果的措施。
This prospective cohort study investigated personal goal achievement and satisfaction with progress in patients with chronic disabling spinal disorders (CDSD). This study examined the relationships between satisfaction with progress and several alternative outcome measures for CDSD patients at least 1 year after completing a functional restoration program (FRP). Treatment outcome measures for CDSD commonly include pain, physical capacities, and functional/vocational status. These factors are weakly correlated and may not reflect individual patients’ perspectives and priorities. Upon enrollment in the FRP, patients’ pre-treatment functional, work, and recreation goals were recorded. Pre- and end-of-program clinical measures included: pain, disability, fear avoidance, lifting, trunk flexibility, and treadmill endurance. At least 1 year after program completion surveys were mailed to consecutive FRP graduates. Non-responders were surveyed by telephone when possible. Surveys included each patient’s personal pre-treatment goals, and assessed Average Pain, SF-36 Physical Function, and satisfaction “with the progress made with your pain problem.” Each patient indicated levels of importance and achievement for each personal goal, and these scores were integrated to yield a goal achievement score (GAS). Linear regression was used to test the relationships between 1-year satisfaction with progress and the following variables: baseline to end-of-program change in clinical measures, and 1-year pain, physical function, and GAS. Of the 106 surveys mailed, 89 (84%) were returned and 86 (81%) had complete data for analysis. None of the pre-post program clinical measures was significantly correlated with satisfaction (overall R2=0.013, p<0.74). In contrast, year-end Average Pain (R2=0.28), Physical Function (R2=0.29), and GAS (R2=0.29) were each significantly correlated (p<.0001) with satisfaction, with a combined R2=0.43, p<.0001. Of these variables, GAS had the highest unique contribution to satisfaction. For CDSD patients one year after completing rehabilitation, compared to more traditional outcomes, goal achievement scores provided the greatest unique contribution to patient satisfaction. Goal achievement may be a valuable patient-centered measure of treatment outcome.