Z Orthop Unfall 2018; 156(04): 385-392
DOI: 10.1055/s-0043-125091
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Krankheitsspezifisches Wissen in der konservativen Therapie der idiopathischen Adoleszentenskoliose

Disease-specific Knowledge in Conservative Treatment of Adolescent Idiopathic Scoliosis
Ferdinand Wagner
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
2   Kinderchirurgische Klinik, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München
3   Institute of Health and Biomedical Innovation, Queensland University of Technology Faculty of Science and Engineering, Brisbane, Australia
,
Julia Brendel
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
,
Esther Dingeldey
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
,
Sebastian Winkler
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
,
Joachim Grifka
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
,
Jan Matussek
1   Orthopädische Klinik der Universität Regensburg, Asklepios Klinikum Bad Abbach
› Author Affiliations
Further Information

Publication History

Publication Date:
07 February 2018 (online)

Zusammenfassung

Hintergrund Die idiopathische Adoleszentenskoliose (IAS) tritt üblicherweise in der Pubertät und damit in einem sensiblen Lebensabschnitt auf. Die konservative Korsetttherapie der IAS erfordert zudem eine hohe Mitarbeit der Patienten. Wie von anderen Erkrankungen bekannt, fördert ein hohes Maß an krankheitsspezifischem Wissen (KSW) den Behandlungserfolg und kann die Lebensqualität (LQ) erhöhen.

Fragestellung Das Ziel der Studie war, das KSW unserer Patienten mit IAS zu überprüfen und Rückschlüsse auf deren Lebensqualität zu ziehen.

Methoden 67 Patienten mit IAS unter konservativer Korsetttherapie wurden gebeten, einen anonymisierten Fragebogen bez. krankheitsspezifischer Fakten zu beantworten. Zusätzlich wurde der SRS-22r-Score der Scoliosis Research Society als Maß für die LQ erhoben.

Ergebnisse Die Hauptinformationsquelle der Patienten stellten das behandelnde Ärzteteam und das Internet dar. Die Mehrheit gab an, verstanden zu haben was Skoliose sei. Detailliertere Fragen ließen jedoch erhebliche Wissenslücken erkennen. Signifikante Unkenntnisse waren insbesondere in den Feldern Therapieregime und Therapieziele vorhanden. Insbesondere die voraussichtliche Dauer der Therapie erschien den meisten Patienten unklar. Eine höhere LQ korrelierte mit hoher Compliance. Patienten, die sich durch die Therapie eine Verbesserung ihres Rückenprofils erhofften, fielen mit einer niedrigeren LQ im Bereich Selbstwahrnehmung auf.

Diskussion Unsere Studie zeigte signifikante Wissenslücken im KSW der Patienten mit IAS auf. Eine optimierte Informationsweitergabe an die Patienten könnte die LQ und auch das Therapieergebnis beeinflussen. Da wir uns als behandelnde Ärzte in der Position der Hauptinformationsquelle befinden, liegt es an uns, diese Situation zu nutzen und zu verbessern.

Abstract

Background The typical onset of adolescent idiopathic scoliosis falls in a sensitive stage of life. Nevertheless, conservative brace treatment requires a high degree of compliance. Disease-specific knowledge influences therapy outcome in many diseases and potentially improves patient compliance and quality of life. We analysed disease-specific knowledge and quality of life of patients with adolescent idiopathic scoliosis.

Methods Scoliosis patients (n = 67) undergoing conservative brace treatment were asked to answer a questionnaire with items about scoliosis-specific knowledge. This was anonymous and prior to regular interviews and examinations. The scoliosis-research-society-22 r score was determined in order to assess quality of life.

Results The major sources of information for the patients were the attending physicians and the world wide web. The majority stated that they understood the nature of scoliosis, although their answers to more detailed questions revealed a major lack of knowledge. A significant gap in provision of information was found, especially in the field of therapy regimen and treatment goals. The expected duration of the therapy was unclear to most patients. Nevertheless, higher quality of life correlated with high compliance and patients who regarded alleviation of the disturbing appearance of their trunk as a main treatment aim also experienced a lower quality of life in the section of self image.

Conclusions Our study revealed a significant lack of disease-specific knowledge in patients with idiopathic scoliosis. Facilitation of knowledge might improve quality of life and therapy outcome in the future. As the attending physicians are the main source of information, it is up to us to improve this situation.

 
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