A mixed methods study to investigate needs assessment for knee pain and disability: population and individual perspectives
A mixed methods study to investigate needs assessment for knee pain and disability: population and individual perspectives
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DOI：
10.1186/1471-2474-8-59
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发表时间：
2007-07-04
影响因子：
2.3
通讯作者：
Richardson, Jane
中科院分区：
文献类型：
--
作者：
Jinks, Clare;Ong, Bie Nio;Richardson, Jane
背景：新的肌肉骨骼服务框架概述了卫生保健需求评估的重要性。我们的目的是为膝关节疼痛和残疾提供一个模型，描述感觉需要（对医疗保健需求的个人评估）和表达需要（对医疗保健的需求）。这种智能是所需的卫生保健规划人员，以实施新的Framework.Methods：多方法的方法。对在3个全科诊所注册的50岁以上成年人进行了一项人群调查（n = 5784）。问卷包含膝关节疼痛筛查工具，用于确定人群中膝关节疼痛的患病率和医疗保健使用情况，以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）。在WOMAC疼痛或身体功能量表上至少有一项评分为“重度”或“极端”的调查应答者被归类为“重度”组。对22名调查应答者进行了定性访谈，以详细探讨膝关节疼痛和残疾的生活经历。一个样本的受访者（n = 10）完成了一个开放格式的病人日记，探讨膝关节疼痛的经验，在日常lives.Results：12个月期间的患病率为49.5%，其中一半是严重的膝关节疼痛。据报告，他们在做家务、弯腰、洗澡、爬楼梯和上下汽车方面有严重困难。一些自我护理正在发生。大多数（53%）患有严重疼痛或残疾的应答者在过去12个月内没有咨询过他们的GP。定性研究揭示了原因，包括一种看法，膝盖疼痛是正常老化的一部分，很少有效的预防和治疗是可用的，使用药物会导致副作用和dependency.Conclusion：这项研究增加了以前的工作，突出了差距之间的感觉和表达的需要和这种不匹配的原因。有证据表明，自我管理，但也错过了有效干预的机会（e。G.生活方式建议）。如果要成功实施新的肌肉骨骼服务框架的各个方面，就需要在临床医生和卫生保健规划者之间采取有针对性的综合方法进行初级和二级预防。
Background: The new Musculoskeletal Services Framework outlines the importance of health care needs assessment. Our aim was to provide a model for this for knee pain and disability, describing felt need (individual assessment of a need for health care) and expressed need (demand for health care). This intelligence is required by health care planners in order to implement the new Framework.Methods: A multi-method approach was used. A population survey (n = 5784) was administered to adults aged 50+ registered with 3 general practices. The questionnaire contained a Knee Pain Screening Tool to identify the prevalence of knee pain and health care use in the population, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Survey responders who scored "severe" or "extreme" on at least one item on the pain or physical function scale on the WOMAC were categorised into "severe" groups. Qualitative interviews were undertaken with 22 survey responders to explore in detail the experience of living with knee pain and disability. A sample of interviewees (n = 10) completed an open format patient diary to explore the experience of knee pain in everyday life.Results: The 12-month period prevalence of knee pain was 49.5%, of which half was severe. Severe difficulties were reported with domestic duties, bending, bathing, climbing stairs and getting in or out of a car. Some self-care is occurring. The majority (53%) of responders with severe pain or disability had not consulted their GP in the last 12 months. The qualitative study revealed reasons for this including a perception that knee pain is part of normal ageing, little effective prevention and treatment is available and the use of medications causes side effects and dependency.Conclusion: This study adds to previous work by highlighting a gap between felt and expressed need and the reasons for this mismatch. There is evidence of self-management, but also missed opportunities for effective interventions (e. g. lifestyle advice). A targeted and integrated approach between clinicians and health care planners for primary and secondary prevention is required if aspects of the new Musculoskeletal Services Framework are to be successfully implemented.