Shoulder patients in primary and specialist health care. A cross-sectional study
Author:
Engebretsen Kaia B.1, Robinson Hilde S.2, Vollestad Nina K.2
Affiliation:
1. Department of Physical Medicine and Rehabilitation , Oslo University Hospital HF , Oslo , Norway 2. Department of Interdisciplinary Health Sciences , Institute of Health and Society, University of Oslo , Oslo , Norway
Abstract
Abstract
Objectives
Shoulder pain is a prevalent problem and has a considerable impact on the use of primary and specialist health care in Norway. It is important to improve short-term recovery and reduce long-term consequences regarding pain and disability, the high costs of treatment and the amount of sick-leave. Treatment for non-specific shoulder pain is mainly non-operative. The aims of this study were to investigate if there are differences in main characteristics, pain and disability (SPADI-score) and psycho-social factors between patients in primary and specialist health care.
Methods
This cross-sectional study included patients consulting physiotherapy in primary health care and patients at an outpatient clinic in specialist health care. Well-known and tested questionnaires for these populations were used and variables were divided into clinical, sociodemographic, psycho-social, and shoulder pain and disability. Descriptive statistics were applied. Two-sample t-test and linear regression were used for continuous data whereas chi-square tests and logistic regression were applied to test differences in categorical data between the two study populations.
Results
Two hundred and 36 patients were recruited from primary health care (FYSIOPRIM, Physiotherapy In Primary Care) and 167 from specialist health care. Patients in primary health care reported less regular use of pain medication (30.7 vs. 61.3%) and fewer patients had symptom duration >12 months (41.9 vs. 51.0%). Furthermore, they reported lower pain intensity, less shoulder pain and disability (SPADI-score), lower scores on psycho-social factors, but higher on expectations of recovery.
Conclusions
Patients with shoulder pain treated in primary health care and in specialist health care are different according to factors such as duration of symptoms, pain and disability, and some of the psycho-social variables. However, the differences are small and the variations within the two study samples is large. Patients treated in primary health care seemed to be less affected and to have higher expectations concerning their recovery. However, based on our results we may question why many patients are referred to specialist health care rather than continuing treatment in primary health care.
Publisher
Walter de Gruyter GmbH
Subject
Anesthesiology and Pain Medicine,Neurology (clinical)
Reference62 articles.
1. Kinge, JM, Knudsen, AK, Skirbekk, V, Vollset, SE. Musculoskeletal disorders in Norway: prevalence of chronicity and use of primary and specialist health care services. BMC Muscoskel Disord 2015;16:75. https://doi.org/10.1186/s12891-015-0536-z. 2. Luime, JJ, Koes, BW, Hendriksen, IJ, Burdorf, A, Verhagen, AP, Miedema, HS, et al.. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004;33:73–81. https://doi.org/10.1080/03009740310004667. 3. Struyf, F, Geraets, J, Noten, S, Meeus, M, Nijs, J. A multivariable prediction model for the chronification of non-traumatic shoulder pain: a systematic review. Pain Physician 2016;19:1–10. 4. Karel, YHJM, Scholten-Peeters, GGM, Thoomes-de, GM, Duijn, E, van Broekhoven, JB, Koes, BW, et al.. Physiotherapy for patients with shoulder pain in primary care: a descriptive study of diagnostic- and therapeutic management. Physiotherapy 2017;103:369–78. https://doi.org/10.1016/j.physio.2016.11.003. 5. Paloneva, J, Koskela, S, Kautiainen, H, Vanhala, M, Kiviranta, I. Consumption of medical resources and outcome of shoulder disorders in primary health care consulters. BMC Muscoskel Disord 2013;14:348. https://doi.org/10.1186/1471-2474-14-348.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|