对纤维肌痛的态度：一项针对加拿大脊椎按摩疗法、自然疗法、物理治疗和职业治疗专业学生的调查。
Attitudes towards fibromyalgia: a survey of Canadian chiropractic, naturopathic, physical therapy and occupational therapy students.
作者信息
Busse Jason W, Kulkarni Abhaya V, Badwall Parminder, Guyatt Gordon H
机构信息
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
出版信息
BMC Complement Altern Med. 2008 May 31;8:24. doi: 10.1186/1472-6882-8-24.
BACKGROUND
The frequent use of chiropractic, naturopathic, and physical and occupational therapy by patients with fibromyalgia has been emphasized repeatedly, but little is known about the attitudes of these therapists towards this challenging condition.
METHODS
We administered a cross-sectional survey to 385 senior Canadian chiropractic, naturopathic, physical and occupational therapy students in their final year of studies, that inquired about attitudes towards the diagnosis and management of fibromyalgia.
RESULTS
336 students completed the survey (response rate 87%). While they disagreed about the etiology (primarily psychological 28%, physiological 23%, psychological and physiological 15%, unsure 34%), the majority (58%) reported that fibromyalgia was difficult to manage. Respondants were also conflicted in whether treatment should prioritize symptom relief (65%) or functional gains (85%), with the majority (58%) wanting to do both. The majority of respondents (57%) agreed that there was effective treatment for fibromyalgia and that they possessed the required clinical skills to manage patients (55%). Chiropractic students were most skeptical in regards to fibromyalgia as a useful diagnostic entity, and most likely to endorse a psychological etiology. In our regression model, only training in naturopathic medicine (unstandardized regression coefficient = 0.33; 95% confidence interval = 0.11 to 0.56) and the belief that effective therapies existed (unstandardized regression coefficient = 0.42; 95% confidence interval = 0.30 to 0.54) were associated with greater confidence in managing patients with fibromyalgia.
CONCLUSION
The majority of senior Canadian chiropractic, naturopathic, physical and occupational therapy students, and in particular those with naturopathic training, believe that effective treatment for fibromyalgia exists and that they possess the clinical skillset to effectively manage this disorder. The majority place high priority on both symptom relief and functional gains when treating fibromyalgia.
背景
纤维肌痛患者频繁使用整脊疗法、自然疗法以及物理和职业疗法的情况已被反复强调，但对于这些治疗师对这种具有挑战性病症的态度却知之甚少。
方法
我们对385名处于学业最后一年的加拿大高级整脊、自然疗法、物理和职业疗法专业学生进行了一项横断面调查，询问他们对纤维肌痛诊断和管理的态度。
结果
336名学生完成了调查（回复率87%）。虽然他们对病因存在分歧（主要是心理因素占28%，生理因素占23%，心理和生理因素占15%，不确定占34%），但大多数（58%）报告称纤维肌痛难以管理。受访者在治疗应优先缓解症状（65%）还是获得功能改善（85%）方面也存在分歧，大多数（58%）希望两者兼顾。大多数受访者（57%）同意存在针对纤维肌痛的有效治疗方法，并且他们具备管理患者所需的临床技能（55%）。整脊专业学生对纤维肌痛作为一个有用的诊断实体最为怀疑，并且最有可能认可心理病因。在我们的回归模型中，只有接受自然疗法培训（非标准化回归系数 = 0.33；95%置信区间 = 0.11至0.56）以及相信存在有效疗法（非标准化回归系数 = 0.42；95%置信区间 = 0.30至0.54）与对管理纤维肌痛患者更有信心相关。
结论
大多数加拿大高级整脊、自然疗法、物理和职业疗法专业学生，特别是那些接受过自然疗法培训的学生，认为存在针对纤维肌痛的有效治疗方法，并且他们具备有效管理这种疾病的临床技能。大多数人在治疗纤维肌痛时高度重视症状缓解和功能改善。
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