アブストラクト
Japanese
| Title | 痛みの破局的思考が大腿骨近位部骨折術後リハビリテーションへ及ぼす影響 |
|---|---|
| Subtitle | 原著 |
| Authors | 田中正一 |
| Authors (kana) | |
| Organization | 医療法人ちゅうざん会ちゅうざん病院リハビリテーション科 |
| Journal | 日本職業・災害医学会会誌 |
| Volume | 70 |
| Number | 3 |
| Page | 72-77 |
| Year/Month | 2022 / 5 |
| Article | 原著 |
| Publisher | 日本職業・災害医学会 |
| Abstract | 要旨: 痛みの破局的思考は術後疼痛, リハビリテーションの結果に影響を及ぼすことが報告されている. そのため, 回復期リハビリテーション病棟の大腿骨近位部骨折術後患者において破局的思考がリハビリテーションへ及ぼす影響について調査した. 4年間に入院した大腿骨近位部骨折術後患者212名中58名を対象とした. 痛みの破局的思考はPain Catastrophizing Scale(PCS)で評価し, 患者を入院時PCS 31点以上のPCS高値群7名と30点以下の対照群51名に分類した. Functional Ambulation Category(FAC), 機能的自立度評価法(Functional Independence measure: FIM), 股関節疼痛Numerical Rating Scale(NRS), Hospital Anxiety and Depression Scale(HADS)を入院時と退院時に評価し, PCS高値群と対照群を比較した. PCS高値群は対照群に比べ入院時, 退院時ともにNRSとHADS不安が有意に高値(P<0.05)であったが, FAC, FIMとHADS抑うつは入院時, 退院時ともに有意差を認めなかった. リハビリテーションを実施することにより, 痛みの破局的思考が重症な患者でも, 歩行や日常生活活動の結果は対照群と変わらなかったが, 疼痛や不安には影響を認めた. そのため, 痛みの破局的思考が重症と考えられる患者には, 心理的なサポートに基づく介入が必要である. |
| Practice | 臨床医学：外科系 |
| Keywords | 大腿骨近位部骨折, 痛みの破局的思考, リハビリテーション, hip fracture, pain catastrophizing, rehabilitation |
English
| Title | The Impact of Pain Catastrophizing on Postoperative Rehabilitation of Hip Fractures |
|---|---|
| Subtitle | |
| Authors | Shoichi Tanaka |
| Authors (kana) | |
| Organization | Department of Rehabilitation Medicine, Chuzan Hospital |
| Journal | Japanese journal of occupational medicine and traumatology |
| Volume | 70 |
| Number | 3 |
| Page | 72-77 |
| Year/Month | 2022 / 5 |
| Article | Original article |
| Publisher | Japanese society of Occupational Medicine and Traumatology |
| Abstract | Pain catastrophizing has been reported to affect postoperative pain and rehabilitation outcomes. Therefore, this study was designed to clarify the impact of pain catastrophizing on rehabilitation of patients after hip fracture surgery in the convalescent rehabilitation ward. The subjects were 58 out of 212 patients after hip fracture surgery who were hospitalized for 4 years. Pain catastrophizing was assessed by the Pain Catastrophizing Scale (PCS), and patients were classified into high PCS group (PCS score >- 31, N = 7) and control group (PCS score <- 30, N = 51) at the admission. Admission and discharge assessments were undertaken: Functional Ambulation Category (FAC), Functional Independence Measure (FIM), hip pain: Numerical Rating Scale (NRS), and Hospital Anxiety and Depression Scale (HADS). The high PCS group and the control group were compared for those admission and discharge assessments. High PCS group showed significantly higher NRS and HADS anxiety than control group at the time of admission and that of discharge (P < 0.05), but there were no significant differences in FAC, FIM, and HADS depression between high PCS group and control group at the time of admission and that of discharge. By performing rehabilitation, the results of rehabilitation for walking and activities of daily living were the same as those of the control patients even in patients with severe pain catastrophizing, but their pain and anxiety were affected. Therefore, patients who are considered to be in higher level of pain catastrophizing need an adequate intervention based on psychological support. |
| Practice | Clinical surgery |
| Keywords | hip fracture, pain catastrophizing, rehabilitation |
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