中国全科医学 ›› 2022, Vol. 25 ›› Issue (34): 4292-4297.DOI: 10.12114/j.issn.1007-9572.2022.0398

所属专题: 中医最新文章合集

• 论著·人群健康研究 • 上一篇    下一篇

社区慢性颈肩痛人群中医健康管理服务实施效果及其影响因素研究:基于目标成就评量法

邱先桃, 任建萍*(), 贺梦妍, 任理仙, 曹庆春, 王锦晶, 王文婷   

  1. 311121 浙江省杭州市,杭州师范大学公共卫生学院
  • 收稿日期:2022-06-20 修回日期:2022-09-09 出版日期:2022-12-05 发布日期:2022-09-19
  • 通讯作者: 任建萍
  • 邱先桃,任建萍,贺梦妍,等.社区慢性颈肩痛人群中医健康管理服务实施效果及其影响因素研究:基于目标成就评量法[J].中国全科医学,2022,25(34):4292-4297.[www.chinagp.net]
    作者贡献:
    邱先桃、任建萍负责文章的构思与设计、论文的修订,并对文章整体负责;邱先桃、任建萍、贺梦妍、任理仙、曹庆春、王锦晶、王文婷负责研究的实施与可行性分析;邱先桃、贺梦妍、任理仙、曹庆春、王锦晶负责数据收集;邱先桃、贺梦妍、王文婷负责数据整理;邱先桃负责统计学处理、结果的分析与解释、论文撰写。
  • 基金资助:
    国家自然科学基金资助项目(71874047)

Traditional Chinese Medicine Health Management for Community-dwelling Individuals with Chronic Neck and Shoulder Pain: Effectiveness Assessed Using Goal Attainment Scaling and Associated Factors

QIU Xiantao, REN Jianping*(), HE Mengyan, REN Lixian, CAO Qingchun, WANG Jinjing, WANG Wenting   

  1. School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
  • Received:2022-06-20 Revised:2022-09-09 Published:2022-12-05 Online:2022-09-19
  • Contact: REN Jianping
  • About author:
    QIU X T, REN J P, HE M Y, et al. Traditional Chinese medicine health management for community-dwelling individuals with chronic neck and shoulder pain: effectiveness assessed using goal attainment scaling and associated factors[J]. Chinese General Practice, 2022, 25 (34) : 4292-4297.

摘要: 背景 颈肩痛的全球疾病经济总负担排名第21名,及时采取规范性的干预措施,可有效治疗疾病,缓解患者的疼痛。运用目标成就评量法可以更加针对性地进行干预效果评估。 目的 基于目标成就评量法分析杭州市社区卫生服务中心中医健康管理综合干预措施在慢性颈肩痛人群中的实施效果及影响因素。 方法 于2020年8—9月,采用典型抽样方法抽取杭州市3家社区卫生服务中心共262例慢性颈肩痛患者作为研究对象,采用自编的调查问卷进行调查,调查内容包括一般情况、长海痛尺表及基于目标成就评量法的调查表。将纳入的调查对象随机分成对照组(n=131)和干预组(n=131)。对照组接受单纯针灸治疗,干预组在此基础上增加综合中医健康管理措施,两组干预时间均为1个月。2020年11月,进行干预效果评估调查。 结果 干预组和对照组均失访9例,最终干预组和对照组各纳入122例颈肩痛患者。两组干预后GAS得分分别为(51.20±7.81)、(42.94±7.57)分,两组比较,差异有统计学意义(P<0.05)。干预后,两组分别有92例(75.4%)、44例(36.1%)患者达到或超过预期目标,两组比较,差异有统计学意义(P<0.05)。干预组不同文化程度、婚姻状况、就业情况、中医体质、自评健康状况的颈肩痛患者干预后GAS得分比较,差异有统计学意义(P<0.05)。多元线性逐步回归分析结果显示,中医体质、自评健康状况、饮酒情况是干预组颈肩痛患者综合干预后GAS得分的影响因素(P<0.05)。 结论 中医健康管理综合干预措施在慢性颈肩痛患者中应用效果显著,提示可在基层医疗卫生机构实施以健康管理为基础的中医综合干预措施。

关键词: 社区卫生服务, 颈痛, 肩痛, 慢性疼痛, 中医健康管理, 目标成就评量法

Abstract:

Background

Neck and shoulder pain ranks the 21st in terms of global economic burden of diseases, but it could be effectively treated and relieved by timely standardized interventions. The application of goal attainment scaling (GAS) will help to assess the effectiveness of interventions in a more targeted manner.

Objective

To measure the effectiveness of traditional Chinese medicine (TCM) health management delivered by Hangzhou community health centers for community-dwelling individuals with chronic neck and shoulder pain using GAS, and to identify the associated factors.

Methods

Typical sampling was adopted to choose 262 patients with chronic neck and shoulder pain from three community health centers of Hangzhou from August to September 2020. They were randomly divided into control group (n=131) and intervention group (n=131) , received one-month acupuncture treatment, and one-month acupuncture treatment plus TCM management, respectively. The intervention effect survey was carried out in November 2020 using a self-compiled questionnaire for understanding participants' demographics, level of pain assessed using the Changhai Pain Rating Scale, and effectiveness measured using GAS.

Results

All the participants were included for analysis (n=244, 122 in each group) except for nine missing cases in each group. The post-intervention GAS scores for intervention group and control group were (51.20±7.81) and (42.94±7.57) , showing statistically significant difference (P<0.05) . The intervention group and control group also had statistically significant difference in terms of the number reaching or exceeding the expected target after intervention〔92 (75.4%) vs 44 (36.1%) 〕 (P<0.05) . The post-intervention GAS score in cases in the intervention group differed significantly by education level, marital status, employment status, TCM constitution, and self-assessment health status (P<0.05) . In accordance with the results of stepwise multiple linear regression analysis, TCM constitution, self-rated health, and drinking were associated with the GAS score after acupuncture treatment plus TCM management (P<0.05) .

Conclusion

The comprehensive TCM health management have significant effect on patients with chronic neck and shoulder pain. In view of this, the management is suggested to be implemented in primary care.

Key words: Community health services, Neck pain, Shoulder pain, Chronic pain, Traditional Chinese medicine health management, Goal attainment scaling