Content » Vol 51, Issue 2

Original report

Comparison of short- and mid-term outcomes of Italian- and German-speaking patients after an interdisciplinary pain management programme in Switzerland: A prospective cohort study

Thomas Benz, Susanne Lehmann, Roberto Brioschi, Achim Elfering, André Aeschlimann, Felix Angst
Rehabilitation clinic “RehaClinic”, Bad Zurzach, Switzerland: E-mail: t.benz@rehaclinic.ch

DOI: 10.2340/16501977-2514

Abstract

Objective: To quantify and compare the course of health-related quality of life of immigrant native Italian-speaking and German-speaking patients before and after an interdisciplinary pain programme.
Design: Prospective cohort study with 1–12 month follow-up.
Subjects: Fibromyalgia, generalized widespread pain, and chronic non-specific back pain patients (Italian-speaking n = 96, German-speaking n = 199).
Methods: Score changes measured with the Short Form 36 (SF-36) were compared with multivariate analysis using standardized mean differences (SMD), adjusted for sex, education and the baseline score.
Results: At baseline, health of the Italian-speaking patients was worse than for the German-speaking patients. Adjusted SMDs showed significantly better improvements in the German group compared with the Italian group: SF-36 Physical functioning SMD = 0.54 (at discharge) and 0.49 (at 12 months), General health SMD = 0.71 and 0.44, Vitality SMD = 0.43 and 0.48 in one sample. In the other sample, the corresponding SMDs were 0.06 (discharge), 0.50 (3 months) and 0.47 (6 months) for Bodily pain.
Conclusion: State of health was better and health improvements were greater in German-speaking patients compared with Italian-speaking patients. Patients with a migration background may have special needs in therapeutic management, and addressing these might enhance the positive outcome in the short- and mid-term.

Lay Abstract

This study examined the health of patients with
chronic pain who participated in a specific rehabilitation programme for chronic pain. Patients’ health was measured before participating in the programme, at the end of the programme, and after the programme. German-speaking patients were compared with Italian-speaking patients. Both groups participated in the same pain management programme with the same therapies, held either in German or in Italian. Italian-speaking and German-speaking patients improved immediately after the programme, but Italian-speaking patient reported lower improvements. The measurements after the programme showed that German-speaking patients could maintain the improvements, whereas the Italian-speaking patients lost the positive effects of the programme over time. In conclusion, Italian-speaking patients may have special needs in pain management and the level of acculturation may influence the results.

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