Background

Understanding how symptoms influence patient judgements of their health informs providers where to direct care. Patient reported physical outcomes (physical function, pain interference) and self-efficacy of symptom management (SEsm)) predict a patient's health state (i.e. patient acceptable symptom state (PASS)). However, it's unclear if therapist should consider a psychological outcome like SEsm separately or combine this outcome with other physical outcomes for clinical decisions.

Objective

To determine if patient reported outcome information system (PROMIS) SEsm scale when combined with PROMIS physical function or pain interference is able to accurately predict a patient's health state defined by PASS.

Methods

One hundred ninety-six patients (initial sample (n = 94) and separate sample (n = 102)) were surveyed by phone after care for a musculoskeletal problem. Patients completed PASS, PROMIS physical function, pain interference and SEsm outcomes. Logistic regression was used to estimate odds ratios (OR) for determining PASS in the initial sample. Criteria for determining PASS developed from the regression analysis were applied to a separate sample to assess accuracy. Accuracy for PASS status were also assessed at 1–7 days and 45–60 days.

Results

Three combinations including SEsm/pain interference and SEsm/physical function showed significant OR's (<0.1) and varied from 2.5 to 4.2 for predicting PASS status. Criteria to predict PASS in the separate sample at 1–7 days and 45–60 days showed accuracies from 74.5% to 83.6%.

Conclusion

This study demonstrates that utilizing SEsm in combination with common physical outcomes used to assess patients with musculoskeletal diagnoses improves prediction of a patient's acceptable level of symptoms and activity.

中文翻译：

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基于 PROMIS 结果的临床标准是否确定了肌肉骨骼问题患者可接受的症状和功能

背景

了解症状如何影响患者对其健康的判断，可以告知提供者在哪里指导护理。患者报告的身体结果（身体功能、疼痛干扰）和症状管理的自我效能（SEsm）可预测患者的健康状态（即患者可接受的症状状态（PASS））。然而，目前尚不清楚治疗师是否应该单独考虑像 SEsm 这样的心理结果，或者将这个结果与其他身体结果结合起来进行临床决策。

客观的

确定患者报告结果信息系统 (PROMIS) SEsm 量表与 PROMIS 身体功能或疼痛干扰相结合是否能够准确预测 PASS 定义的患者健康状态。

方法

196 名患者（初始样本 (n = 94) 和单独样本 (n = 102)）在治疗肌肉骨骼问题后接受电话调查。患者完成 PASS、PROMIS 身体功能、疼痛干扰和 SEsm 结果。Logistic 回归用于估计优势比 (OR)，以确定初始样本中的 PASS。从回归分析得出的确定 PASS 的标准被应用于单独的样本以评估准确性。还在 1-7 天和 45-60 天评估 PASS 状态的准确性。

结果

包括 SEsm/疼痛干扰和 SEsm/身体功能在内的三种组合显示出显着的 OR (<0.1)，并且在预测 PASS 状态时从 2.5 到 4.2 不等。在 1-7 天和 45-60 天的单独样本中预测 PASS 的标准显示准确度为 74.5% 至 83.6%。

结论

该研究表明，将 SEsm 与用于评估肌肉骨骼诊断患者的常见身体结果相结合，可以提高对患者可接受的症状和活动水平的预测。