COVID-19大流行對膝骨關節炎老人術前健康相關生活品質的衝擊

Impact of the COVID-19 Pandemic on Health-Related Quality of Life in Older Adults With Preoperative Knee Osteoarthritis

10.6224/JN.202306_70(3).05

趙珮玉(Pei-Yu CHAO)；李麗雲(Li-Yun LEE)

老人 ； 膝骨關節炎 ； 關節炎嚴重度 ； 健康相關生活品質 ； older adult ； knee osteoarthritis ； osteoarthritis severity ； health-related quality of life

護理雜誌

70卷3期（2023 / 06 / 01）

26 - 36

繁體中文;英文

背景：膝骨關節炎（knee osteoarthritis）是全球老人常見的疾病，COVID-19疫情下生活品質受影響。目的：本研究目的探討COVID-19疫情下，膝骨關節炎老人等待膝關節置換術前的關節炎嚴重度與健康相關生活品質現況及生活品質預測因子。方法：採橫斷式相關性研究設計，方便取樣，2020年6月至2021年6月於中部某區域教學醫院骨科病房收案。測量工具包含關節炎嚴重度量表（Western Ontario and McMaster Universities Osteoarthritis Index）、健康相關生活品質量表。統計分析以皮爾森積差相關分析、獨立t檢定及單因子變異數分析基本屬性、關節炎嚴重度與生活品質相關性，多元逐步迴歸分析其生活品質預測因子。結果：本研究共收案60位，平均年齡70歲。膝骨關節炎嚴重度平均分數為70.45分。男性、有共病症及每月可支配收入越多者，生理範疇生活品質比較差。然而，膝蓋疼痛、僵硬及身體功能受限越嚴重，心理範疇生活品質越佳。結論／實務應用：COVID-19大流行期間，老人膝骨關節炎的嚴重度會影響術前的生活品質。臨床人員應及早偵測出並提供照護介入以改善術前生活品質。

Background: Knee osteoarthritis is prevalent in older adults worldwide. Quality of life was negatively affected by the COVID-19 pandemic. Purpose: This study was designed to examine osteoarthritis severity and health-related quality of life (QOL) in older adults with knee osteoarthritis before total knee replacement during the COVID-19 pandemic and to identify the related predictors of QOL. Methods: This cross-sectional correlation study involved convenience sampling in the orthopedic ward of a regional teaching hospital in central Taiwan from June 2020 to June 2021 using the Western Ontario and McMaster Universities Arthritis Index and the SF-36v2 Health Survey. The data were analyzed using Pearson's correlation coefficient analysis, independent samples t test, and one-way analysis of variance to determine correlations among demographic variables, osteoarthritis severity, and QOL. The predictors of QOL were examined using stepwise multiple linear regression analysis. Results: A total of 60 older adults diagnosed with knee osteoarthritis were sampled. The average age was 70 years and the average osteoarthritis severity score was 70.45. Being male, having comorbidities, and having a relatively high level of monthly disposable income were associated with poorer QOL. Moreover, more severe knee pain, stiffness, and physical dysfunction were associated with better psychological QOL. Conclusions/ Implications for Practice: During the COVID-19 pandemic, the severity of knee osteoarthritis affects preoperative quality of life in older adults. Clinicians should detect signs of pain and physical dysfunction in these patients in advance and intervene in a timely manner to improve their QOL before surgery.

1. 李淑芳, G. S.-F.,王秀華, H.-H.(2012)。退化性膝關節炎患者健康相關生活品質之決定因子。大專體育學刊，14(3)，387-398。
   連結：
2. Battista, S.,Dell’Isola, A.,Manoni, M.,Englund, M.,Palese, A.,Testa, M.(2021).Experience of the COVID-19 pandemic as lived by patients with hip and knee osteoarthritis: An Italian qualitative study.BMJ Open,11(10),e053194.
3. Bellamy, N.,Buchanan, W. W.,Goldsmith, C. H.,Campbell, J.,Stitt, L. W.(1988).Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.The Journal of Rheumatology,15(12),1833-1840.
4. Brandt, K. D.,Fife, R. S.,Braunstein, E. M.,Katz, B.(1991).Radiographic grading of the severity of knee osteoarthritis: Relation of the Kellgren and Lawrence grade to a grade based on joint space narrowing, and correlation with arthroscopic evidence of articular cartilage degeneration.Arthritis & Rheumatism,34(11),1381-1386.
5. Cui, A.,Li, H.,Wang, D.,Zhong, J.,Chen, Y.,Lu, H.(2020).Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies.eClinical Medicine,29,100587.
6. Fang, W.-H.,Huang, G.-S.,Chang, H.-F.,Chen, C.-Y.,Kang, C.-Y.,Wang, C.-C.,Lin, C.,Yang, J.-H.,Su, W.,Kao, S.,Su, S.-L.(2015).Gender differences between WOMAC index scores, health-related quality of life and physical performance in an elderly Taiwanese population with knee osteoarthritis.BMJ Open,5(9),e008542.
7. Ghomrawi, H. M. K.,Mushlin, A. I.,Kang, R.,Banerjee, S.,Singh, J. A.,Sharma, L.,Flink, C.,Nevitt, M.,Neogi, T.,Riddle, D. L.(2020).Examining timeliness of total knee replacement among patients with knee osteoarthritis in the U.S.: Results from the OAI and MOST longitudinal cohorts.The Journal of Bone and Joint Surgery,102(6),468-476.
8. Gomes-Neto, M.,Araujo, A. D.,Junqueira, I. D. A.,Oliveira, D.,Brasileiro, A.,Arcanjo, F. L.(2016).Comparative study of functional capacity and quality of life among obese and non-obese elderly people with knee osteoarthritis.Revista Brasileira de Reumatologia,56(2),126-130.
9. Guerrero, M.,Castroman, P.,Quiroga, O.,Berenguel Cook, M.,Narvaez Tamayo, M. A.,Venturoni, L.,Pergolizzi, J., Jr.,Rekatsina, M.,Varrassi, G.(2022).Pain management and COVID-19: A Latin American perspective.Cureus,14(3),e23100.
10. Ho, K. W.,Pong, G.,Poon, W. C.,Chung, K. Y.,Kwok, Y.-Y.,Chiu, K. H.(2021).Progression of health-related quality of life of patients waiting for total knee arthroplasty.Journal of Evaluation in Clinical Practice,27(1),69-74.
11. Huang, K.-H.,Hsieh, R. L.,Lee, W. C.(2017).Pain, physical function, and health in patients with knee osteoarthritis.Rehabilitation Nursing,42(4),235-241.
12. Huang, Y.-L.,Tsay, W.-I.,Her, S.-H.,Ho, C.-H.,Tsai, K.-T.,Hsu, C.-C.,Wang, J.-J.,Huang, C.-C.(2020).Chronic pain and use of analgesics in the elderly: A nationwide population-based study.Archives of Medical Science,16(3),627-634.
13. Kan, H. S.,Chan, P. K.,Chiu, K. Y.,Yan, C. H.,Yeung, S. S.,Ng, Y. L.,Shiu, K. W.,Ho, T.(2019).Non-surgical treatment of knee osteoarthritis.Hong Kong Medical Journal,25(2),127-133.
14. Katz, J. N.,Arant, K. R.,Loeser, R. F.(2021).Diagnosis and treatment of hip and knee osteoarthritis: A review.JAMA,325(6),568-578.
15. Kellgren, J. H.,Lawrence, J. S.(1957).Radiological assessment of osteo-arthrosis.Annals of the Rheumatic Diseases,16(4),494-502.
16. Lange, J. K.,Yang, H. Y.,Collins, J. E.,Losina, E.,Katz, J. N.(2020).Association between preoperative radiographic severity of osteoarthritis and patient-reported outcomes of total knee replacement.JB & JS Open Access,5(3),e19.00073.
17. Larghi, M. M.,Grassi, M.,Luca, F.,Placenza, E.,Rampulla, C.,Manzotti, A.(2020).Clinical outcome before and after COVID-19 quarantine in patients affect of knee and hip osteoarthritis.Acta Biomedica,91(4),e2020150.
18. Lee, T.-S.,Liu, H.-C.,Tsaur, W.-G.,Lee, S.-P.(2021).Monthly disposable income is a crucial factor affecting The quality of life in patients with knee osteoarthritis.Healthcare,9(12),1703.
19. Lopez-Olivo, M. A.,Ingleshwar, A.,Landon, G. C.,Siff, S. J.,Barbo, A.,Lin, H. Y.,Suarez-Almazor, M. E.(2020).Psychosocial determinants of total knee arthroplasty outcomes two years after surgery.ACR Open Rheumatology,2(10),573-581.
20. Mohd Yusuf, S. Y.,Md-Yasin, M.,Mohd Miswan, M. F.(2022).Does less pain predict better quality of life among Malaysian patients with mild-moderate knee osteoarthritis?.Clinics and Practice,12(2),219-230.
21. Neogi, T.(2013).The epidemiology and impact of pain in osteoarthritis.Osteoarthritis and Cartilage,21(9),1145-1153.
22. Rao, Y.,Xu, X.,Liu, D.,Reis, C.,Newman, I. M.,Qin, L.,Sharma, M.,Shen, J.,Zhao, Y.(2018).Health-related quality oflife in patients with arthritis: A cross-sectional survey among middle-aged adults in Chongqing, China.International Journal of Environmental Research and Public Health,15(4),768.
23. Salaffi, F.,Leardini, G.,Canesi, B.,Mannoni, A.,Fioravanti, A.,Caporali, R.,Lapadula, G.,Punzi, L.(2003).Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index in Italian patients with osteoarthritis of the knee.Osteoarthritis and Cartilage,11(8),551-560.
24. Shalhoub, M.,Anaya, M.,Deek, S.,Zaben, A. H.,Abdalla, M. A.,Jaber, M. M.,Koni, A. A.,Zyoud, S. H.(2022).The impact of pain on quality of life in patients with osteoarthritis: A cross-sectional study from Palestine.BMC Musculoskeletal Disorders,23(1),248.
25. Swain, S.,Sarmanova, A.,Mallen, C.,Kuo, C. F.,Coupland, C.,Doherty, M.,Zhang, W.(2020).Trends in incidence and prevalence of osteoarthritis in the United Kingdom: Findings from the clinical practice research datalink (CPRD).Osteoarthritis and Cartilage,28(6),792-801.
26. Vitaloni, M.,Botto-van Bemden, A.,Sciortino Contreras, R. M.,Scotton, D.,Bibas, M.,Quintero, M.,Monfort, J.,Carné, X.,de Abajo, F.,Oswald, E.,Cabot, M. R.,Matucci, M.,du Souich, P.,Möller, I.,Eakin, G.,Verges, J.(2019).Global management of patients with knee osteoarthritis begins with quality of life assessment: A systematic review.BMC Musculoskeletal Disorders,20(1),493.
27. Ware, J. E.,Snow, K. K.,Kosinski, M.,Gandek, B.(1993).SF-36 health survey: Manual and interpretation guide.The Health Institute New England Medical Center.
28. Zhou, K.,Zhuang, G.,Zhang, H.,Liang, P.,Yin, J.,Kou, L.,Hao, M.,You, L.(2013).Psychometrics of the short form 36 health survey version 2 (SF-36v2) and the quality of life scale for drug addicts (QOL-DAv2.0) in Chinese mainland patients with methadone maintenance treatment.PLOS ONE,8(11),e79828.
29. 衛生福利部疾病管制署（2020，7月9日）．台灣 COVID-19的預防與控制。[Taiwan Centers for Disease Control, ROC. (2020, July 9). Prevention and control of COVID-19 in Taiwan.] https://www.cdc.gov.tw/En/Category/Page/0vq8rsAob_9HCi5GQ5jH1Q
30. 衛生福利部統計處（2020，11月）．民國108年西醫門診（不含急診）件數統計－按疾病別及健保業務組縣市別分。[Department of Statistics, Ministry of Health and Welfare, Taiwan, ROC. (2020, November). Case numbers in Western medicine outpatient clinics: By BNHI branch, locale, and illness, 2019.] https://www.mohw.gov.tw/dl-16400-7a4bf9b5-b535-442b-bdc1-fbffb80d1719.html