Billis Evdokia V, McCarthy Christopher J, Stathopoulos Ioannis, Kapreli Eleni, Pantzou Paulina, Oldham Jacqueline A
Department of Physiotherapy, Axhool of Health and Caring Professions, Technological Education Institute of Lamia, Lamia, Greece.
J Eval Clin Pract. 2007 Jun;13(3):337-45. doi: 10.1111/j.1365-2753.2006.00698.x.
RATIONALE, AIMS AND OBJECTIVES: Identifying homogenous subgroups of low back pain (LBP) patients is considered a priority in musculoskeletal rehabilitation and is believed to enhance clinical outcomes. In order to achieve this, the specific features of each subgroup need to be identified. The aim of this study was to develop a list of clinical and cultural features that are included in the assessment of LBP patients in Greece, among health professionals. This 'list' will be, utilized in a clinical study for developing LBP subgroups.
Three focus groups were conducted, each one comprising health professionals with homogenous characteristics and all coordinated by a single moderator. There were: 11 physiotherapists (PTs) with clinical experience in LBP patients, seven PTs specialized in LBP management, and five doctors with a particular spinal interest. The focus of discussions was to develop a list of clinical and cultural features that were important in the examination of LBP. Content analysis was performed by two researchers.
Clinicians and postgraduates developed five categories within the History (Present Symptoms, History of Symptoms, Function, Psychosocial, Medical History) and six categories within the Physical Examination (Observation, Neurological Examination, Active and Passive Movements, Muscle Features and Palpation). The doctors identified four categories in History (Symptomatology, Function, Psychosocial, Medical History) and an additional in Physical Examination (Special Tests). All groups identified three cultural categories; Attitudes of Health Professionals, Patients' Attitudes and Health System influences.
An extensive Greek 'list' of clinical and cultural features was developed from the groups' analysis. Although similarities existed in most categories, there were several differences across the three focus groups which will be discussed.
原理、目的和目标：识别下背痛（LBP）患者的同质亚组被认为是肌肉骨骼康复的首要任务，并且相信这会提高临床疗效。为了实现这一点，需要确定每个亚组的具体特征。本研究的目的是制定一份希腊卫生专业人员在评估LBP患者时所包含的临床和文化特征清单。这份“清单”将用于一项关于LBP亚组的临床研究。
进行了三个焦点小组讨论，每个小组由具有同质特征的卫生专业人员组成，且均由一名主持人协调。小组分别为：11名有LBP患者临床经验的物理治疗师（PT）、7名专门从事LBP管理的PT以及5名对脊柱有特别兴趣的医生。讨论的重点是制定一份在LBP检查中重要的临床和文化特征清单。由两名研究人员进行内容分析。
临床医生和研究生在病史（现症状、症状史、功能、心理社会、病史）中确定了五类，在体格检查（观察、神经学检查、主动和被动活动、肌肉特征和触诊）中确定了六类。医生们在病史中确定了四类（症状学、功能、心理社会、病史），在体格检查中还确定了一类（特殊检查）。所有小组都确定了三类文化特征；卫生专业人员的态度、患者的态度和卫生系统的影响。
通过小组分析制定了一份广泛的希腊临床和文化特征“清单”。尽管大多数类别存在相似之处，但三个焦点小组之间存在一些差异，将对此进行讨论。
