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ORIJINAL ARAŞTIRMA

Kronik Bel Ağrısında Hasta Memnuniyeti: Farmakolojik Tedavi, Fizik Tedavi ve Nöral Terapi Karşılaştırması
Patient Satisfaction in Chronic Low Back Pain: A Comparison Between Pharmacological Treatment, Physiotherapy and Neural Therapy
Received Date : 31 Dec 2020
Accepted Date : 12 Apr 0021
Available Online : 10 May 2021
Doi: 10.31609/jpmrs.2020-80720 - Makale Dili: EN
J PMR Sci. 2021;24(3):238-43
ÖZET
Amaç: Bu çalışmanın amacı, 1- hem farmakolojik tedavi ve non-farmakolojik tedavi alan, ayrıca non-farmakolojik tedavi olarak fizik tedavi ve nöral terapi alan kronik bel ağrılı hastaların hasta memnuniyeti ve ağrı değişimi düzeylerini kıyaslamak, 2- hem de hangi demografik faktörlerin hasta memnuniyeti ile daha ilişkili olduğunu incelemektir. Gereç ve Yöntemler: Bu çalışmaya kronik bel ağrısı olan toplam 109 hasta kabul edilmiştir. Hastalar 2 gruba ayrılmıştır: farmakolojik tedavi grubunu steroid olmayan antiinflamatuar ve kas gevşetici ilaç tedavisi alan 49 hasta, farmakolojik olmayan tedavi grubunu da 60 hasta oluşturmuştur (fizik tedavi uygulanan 25 hasta ve nöral terapi uygulanan 35 hasta). Hastaların demografik verileri, hasta tatmin memnuniyeti (5 soru ile) hastaların hangi tedavi yöntemi aldığını bilmeyen bir klinisyen tarafından telefon görüşmesi ile kaydedilmiştir. Bulgular Yaş, cinsiyet, kronik hastalık varlığı, çalışma durumu, eğitim durumu ve hasta memnuniyeti arasında bir ilişki saptanmamıştır. Farmakolojik olmayan tedavi alan hastaların, tüm hasta memnuniyeti verileri farmakolojik tedavi alan hastalara göre istatistiksel olarak belirgin olarak daha iyi bulunmuştur (p<0,001). Farmakolojik olmayan tedavi alan hastalar incelendiğinde; ağrı azalma yüzdesi (p<0,001), bu tedaviyi yeniden deneme isteği (p<0,001) ve hasta memnuniyet skoru (p=0,001) nöral tedavi uygulanan hastalarda daha yüksek saptanmıştır. Sonuç Kronik bel ağrılı hastalarda hem fizik tedavi, hem de nöral tedavi yöntemi, farmakolojik tedaviye göre belirgin fazla bir hasta memnuniyeti sağlamaktadır, ayrıca ağrı azalması hem nöral terapi hem de fizik tedavi grubunda belirgin düzeyde fazla saptanmıştır. Bu çalışmada, en fazla hasta memnuniyeti ve ağrıda azalma sağlayan yöntem nöral terapi olarak bulunmuştur. Nöral terapinin ağrı ve hasta memnuniyeti üzerine etkisi göz önüne alındığında, fizik tedavi yöntemlerine iyi bir alternatif oluşturabilir.
ABSTRACT
Objective: The aim of this study is 1- to compare both the patient satisfaction and pain relief between patients who received pharmacological treatment and non-pharmacological treatment, also between patients who received physiotherapy and neural therapy in chronic low back pain, 2-to evaluate which demographic factors are associated with patient satisfaction mostly. Material and Methods: A total of 109 patients with chronic low back pain was enrolled to this study and divided into two groups: pharmacological treatment (n=49) as non-steroid antiinflammatory and myorelaxant drugs and non-pharmacological treatment (n=60) (25 patients who had only physiotherapy and 35 patients who had only neural therapy). Demographic characteristics and patient satisfaction variables (with 5 questions) was examined by a single blind physician with phone interview. Results: There was no relation between age, gender, having any chronic disease, working status, educational status and patient satisfaction in all patients. All patient satisfaction variables (p<0.001) were significantly better in patients who received non-pharmacological treatment than patients who received only pharmacological treatment. When patients who received only non-pharmacological treatment were evaluated; percentage of the pain relief (p<0.001) willingness to try this treatment again (p=0.001) and patient satisfaction score (p<0.001) were significantly higher in neural therapy group than physiotherapy group. Conclusion: Both physiotherapy and neural therapy have higher patient satisfaction than pharmacological treatment in chronic low back pain, furthermore the pain relief was significantly better in both physiotherapy and neural therapy methods. However the group with the most pain relief and patient satisfaction was found to be neural therapy group in our study. Considering the effect of neural therapy on pain, patient satisfaction, it seems to be a good alternative to physiotherapy.
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