ABSTRACT
INTRODUCTION: There is limited research on the long-term benefits of an interdisciplinary pain rehabilitation, even though short-term benefits have been well documented. The present study evaluated the effects of an interdisciplinary pain rehabilitation program with a three-year follow-up. A special emphasis was placed on economic evaluation of the treatment from a societal perspective. MATERIAL AND METHODS: The study was conducted at the chronic pain unit of the Reykjalundur rehabilitation center. Every fifth patient referred to the Reykjalundur Rehabiliation Center pain clinic was randomized to participate in this study. Data was collected over the course of 4,5 years with a three years follow-up. Finally, economic evaluation was conducted at the end of the research. RESULTS: After treatment patients experienced less pain, fear and avoidance, anxiety and depression symptoms and improved social functioning. Work ability increased from 36% to 47% at the end of rehabilitation and continued to rise to 57% at three year follow-up. Economic evaluation from a societal perspective showed that cost associated with the rehabilitation had leveled out in three years and continued throughout life. CONCLUSION: The results indicate that interdisciplinary rehabilitation for chronic pain has a positive impact on function and the experience of pain as well as positive psychosocial effect. An economic evaluation of the treatment shows that the rehabilitation is very cost effective and that each Icelandic krona (IKR) spent is returned eightfold back to society.
Subject(s)
Chronic Pain/economics , Chronic Pain/rehabilitation , Health Care Costs , Interdisciplinary Communication , Pain Management/economics , Patient Care Team/economics , Chronic Pain/diagnosis , Chronic Pain/psychology , Cooperative Behavior , Cost-Benefit Analysis , Functional Status , Humans , Iceland , Program Evaluation , Return to Work , Time Factors , Treatment OutcomeABSTRACT
Se realizó una intervención terapéutica en 128 pacientes con dolor por espolón calcáneo, seleccionados aleatoriamente, quienes fueron tratados en el Departamento de Rehabilitación del Hospital General Docente "Orlando Pantoja Tamayo" en el municipio de Contramaestre, de la provincia de Santiago de Cuba, de enero del 2014 a abril del 2015, con vistas a evaluar la efectividad de la terapia Su-Jok. Se conformaron 2 grupos: uno de control, que recibió tratamiento convencional, y otro de estudio, en el cual se aplicó la terapia Su-Jok. Luego de efectuado el análisis estadístico mediante las pruebas de hipótesis de homogeneidad de la Χ² y de diferencias de medias (ambas técnicas con un error permisible de 5 %), pudo concluirse que la terapia Su Jok es efectiva para aliviar el dolor por espolón calcáneo, por lo que se recomendó promoverla para ello debido a su fácil empleo y bajo costo.
A therapeutic intervention was carried out in 128 randomly selected patients with pain due to heel spur, who were treated in the Rehabilitation Department of "Orlando Pantoja Tamayo" Teaching General Hospital in Contramaestre municipality, Santiago de Cuba province, from January, 2014 to April, 2015, with the aim of evaluating the effectiveness of the Su-Jok therapy. Two groups were formed: a control group which received conventional treatment, and a study group, in which the Su-Jok therapy was applied. After the statistical analysis was carried out by means of the homogeneity and hypothesis tests of homogeneity of Χ2 and the means differences (both techniques with a permissible error of 5%), it could be concluded that the Su-Jok therapy is effective to mitigate the pain due to heel spur, so it was recommended to promote it taking into account its easy use and low cost.
Subject(s)
Pain Measurement , Heel Spur , Medicine, Korean TraditionalABSTRACT
Introdução: Dor no pós-operatório imediato de herniorrafias inguinais é um achado comum à realização do procedimento. Dessa forma, sua avaliação após a cirurgia de correção de hérnia, seja pela técnica videolaparoscópica ou pela técnica de Lichtenstein é de extrema importância para auxiliar o cirurgião na escolha do procedimento mais adequado para cada situação.Objetivo: Avaliar a intensidade da dor no pós-operatório imediato do reparo cirúrgico das hérnias inguinais, comparando a técnica de Lichtenstein com a cirurgia videolaparoscópica. Material e métodos: O trabalho foi realizado prospectivamente utilizando-se um protocolo previamente desenvolvido pelo autor com a utilização de uma Escala Análogo Visual (EAV). Os pacientes dos dois grupos (cirurgia convencional e cirurgia videolaparoscópica) foram pareados por faixa etária, sexo e Índice de Massa Corporal (IMC). Através da EAV, os pacientes determinavam a intensidade da dor (0 - 10) no pós-operatório imediato (24 horas após a realização do procedimento). A análise dos dados foi feita através do teste t de Student.Resultados: Foram analisados 62 pacientes, no entanto 22 foram excluídos pela impossibilidade de pareamento. Os 40 pacientes participantes deste estudo foram pareados por faixa etária, sexo e IMC. No grupo de pacientes que realizou a técnica de Lichtenstein (20 pacientes) a nota média para avaliação da dor foi de 3,9, enquanto o grupo que realizou a cirurgia por vídeo (20 pacientes) teve uma média de 4,1.Discussão e conclusão: No presente estudo não há diferença entre a intensidade de dor causada pelo procedimento convencional e videolaparoscópico após 24 horas da realização da cirurgia.
Subject(s)
Humans , Male , Adult , Middle Aged , Hernia, Inguinal/surgery , Pain Measurement/methods , Postoperative PeriodABSTRACT
PROBLEM: Two methods for the assessment of change are evaluated: (1) subjects' ratings of the outcome taken after termination of the treatment, and (2) comparison of test scores taken before the beginning and after termination of the treatment. METHODS: Included in the analysis are 82 subjects with chronic headache and/or back pain who participated in psychological group treatment for pain. They were given an outcome rating scale with 15 items (ORS) after therapy in addition to pain diaries and questionnaires for the assessment of physical symptoms, mood and quality of life. Diaries and questionnaires were filled in twice, before and after therapy. RESULTS: The ORS demonstrates satisfying psychometric properties. Internal consistency is 0.94 (Cronbach's alpha) and retest reliability is 0.74. Correlations of this scale with outcome criteria based on pre-post comparisons, however, are mostly nonsignificant. Significant correlations are found when the ORS scores are related to the questionnaire scores after therapy. CONCLUSION: It is concluded that, contrary to the formulation of the items, the ORS scale does not so much assess change, but rather depicts the state of the subjects at the time the assessment is made.
