中醫門診骨關節炎病人的症狀描述

研究背景：病人對於症狀描述與醫療人員不同，病人對自身症狀的描述較多元。研究目的：了解中醫門診骨關節炎病人對症狀的描述。研究方法：2019年12月至2020年4月，於某區域醫院中醫門診求醫者為研究對象。邀請符合第十版國際疾病分類標準之骨關節炎診斷碼，且同意訪談過程全程錄音者為研究對象。將訪談逐字稿依疼痛相關、關節表現、日常活動困難、其它身體症狀等類別，進行分類、編碼與統計次數。結果：8位受訪者最常提到的不適部位為膝關節，且不侷限於一個關節；遇冷及長時間重複關節動作，是疼痛加劇的主要因素；疼痛導致日常活動受限。病人使用日常生活經驗、身體感受、活動受限情形、肢體語言與中西醫術語等描述症狀。結論：病人用生活經驗、身體感受、肢體語言與中西醫術語等，描述其疼痛、活動困難、關節表現與其它等症狀。這樣結果與文獻及臨床用語不盡相同。醫護人員應了解病人對症狀的描述，以提高照護品質。

關鍵字

病人；骨關節炎；症狀描述；中醫門診

並列摘要

Research background: Patients have different ways in describing their symptoms to medical professionals. Research purpose :To understand the symptoms described by osteoarthritis patients in an outpatient Chinese medicine clinic. Research method: The research subjects are patients seeking medical treatment in a Chinese medicine clinic of a regional hospital between December 2019 and April 2020. Patients qualifying for the osteoarthritis diagnostic criteria of the International Statistical Classification of Diseases and Related Health Problems 10th Revision and who agreed to the recording of the whole interview process were invited to participate in the study. Pain-related, joint symptoms, difficulty in daily activities and other physical symptoms described during the interview were transcribed verbatim, coded and counted. Results: The most commonly mentioned discomfort location in the 8 interviewees was the knee joint, and not limited to one joint. Encounter cold temperature and repeated joint movements over a length of time are the main cause of aggravation, and the pain led to limited daily activities. In addition,other physical symptoms. The patients described their symptoms in terms of daily life experience, physical sensations, restricted activity, body language, and Chinese and Western medical terms, etc. describe symptoms. Conclusion: Patients use to daily life experience, physical sensations, body language, and Chinese and Western medical terms, etc, description of pain, difficult activities, articular manifestation and other physical symptoms described. This is different from the literature and clinical terms. The medical staff should understand the patient's description of the symptoms to improve the quality of care.

並列關鍵字

patient ； osteoarthritis ； symptom description ； chinese medicine

參考文獻

陳毓璟 (2011)．退化性膝關節炎中老年病人之疾病認知與因應。健康促進與衛生教育學報，36, 1-30。https://doi.org/10.7022/jhphe.201112.0001

戴念國、陳美惠、鄭誠功 (2019)．骨關節炎之治療發展－從中草藥芳香輔助療法、運動治療到再生醫學。中醫本草芳香療法期刊，3 (2) 15-34 https://doi.org/10.6763/ijtcma.201911_3(2).0002

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Finney, A. G., Healey, E. L., Lewis, M., Ryan, S., Dziedzic, K. S. (2013). OP0204-PC Multisite peripheral joint pain in the community: Prevalence and impact in the North West Midlands, United Kingdom (UK). Annals of the Rheumatic Diseases, 72 (Suppl 3), A121. https://doi.org/10.1136/annrheumdis-2013-eular.409

Herrero-Beaumont, G., Roman-Blas, J. A., Bruyère O., Cooper, C., Kanis, J., Maggi, S., Rizzoli, R., & Reginster, J, Y, (2017). Clinical settings in knee osteoarthritis: Pathophysiology guides treatment. Maturitas, 96, 54-57. https://doi.org/10.1016/j.maturitas.2016.11.013

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