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首页> 外文期刊>German Medical Science >Subgroups in chronic low back pain patients – a step toward cluster-based, tailored treatment in inpatient standard care: On the need for precise targeting of treatment for chronic low back pain
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Subgroups in chronic low back pain patients – a step toward cluster-based, tailored treatment in inpatient standard care: On the need for precise targeting of treatment for chronic low back pain

机译：慢性下腰痛患者的亚组–向住院标准护理中的基于集群的，量身定制的治疗迈出的一步：需要针对慢性下腰痛的治疗精准定位

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Objective: The purpose of this study was to find applicable clusters for the development of different treatment pathways in an inpatient multimodal pain-therapy setting based on the multifaceted nature of CLBP. Methods: Based on data of questionnaires (Hospital Anxiety and Depression Scale (HADS), Marburg Questionnaire on Habitual Health Findings (MFHW), quality of life assessment using the Short-Form 12 (SF 12)), a retrospective two-step cluster analysis involving a sample of chronic low back pain (CLBP) patients (N=320) was calculated. Subsequently, the clusters were precisely described and compared on the basis of further data collected during the patients’ standard care: pain characteristics, socio-demographic data and the general state of health, psychological variables, therapy intensity, and Diagnosis Related Groups (DRG) data. Results: We found a three-cluster solution: little psychological interference but marginal physical and mental quality of life (Cluster 1); poor well-being, low physical quality of life, and marginal mental quality of life (Cluster 2); and heavy mental strain and marginal physical quality of life (Cluster 3). Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP.
机译：目的：本研究的目的是根据CLBP的多方面性质，为在住院患者多模式疼痛治疗环境中寻找不同治疗途径发展的适用人群。方法：根据问卷数据（医院焦虑和抑郁量表（HADS），马尔堡习惯健康调查问卷（MFHW），使用简表12（SF 12）的生活质量评估）进行回顾性两步聚类分析计算了涉及慢性腰背痛（CLBP）患者（N = 320）的样本。随后，根据患者标准护理期间收集的更多数据对疼痛的簇进行精确描述和比较：疼痛特征，社会人口统计学数据和总体健康状况，心理变量，治疗强度和诊断相关组（DRG）数据。结果：我们发现了一种三类解决方案：心理干预很少，但是身心生活却微不足道（第一类）;健康状况不佳，生活质量低下，心理生活质量低下（第二组）;以及严重的精神紧张和边缘的生活质量（第3组）。结论：与以前的研究相似，我们的结果表明，患有CLBP的患者在精神负担的大小和存在身体障碍方面存在差异。这些差异确定了需要精确靶向治疗CLBP的需要。因此，基于关于CLBP的形式，差异和关系的复杂知识，住院患者疼痛中心应提供不同的多模式治疗途径并整合有意义的分类，并考虑到CLBP的多面性。

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