Rehabilitation Research Unit, Kings College London, London, UK.
BMC Musculoskelet Disord. 2010 Feb 11;11:31. doi: 10.1186/1471-2474-11-31.
To explore the health beliefs, experiences, treatment and expectations of people with chronic knee pain, and investigate if, how and why these change after taking part on an integrated exercise-based rehabilitation programme--Enabling Self-management and Coping with Arthritis knee Pain through Exercise, ESCAPE-knee pain.
Semi-structured interviews were conducted with people with chronic knee pain, before (n=29) and after (n=23) participation on the programme. Thematic analysis was used to document people's baseline health beliefs, attitudes and cognitions, and to see if how and why these changed after completing the programme.
Initially people had poor understanding and negative, fatalistic beliefs about the management or prognosis for knee pain. Following the programme the majority of participants had positive experiences describing improvement in pain, physical and psychosocial functioning, greater knowledge and understanding of their condition and treatment options, and in their ability to use exercise to control symptoms. Beliefs about the causation and prognosis of knee pain were unchanged, but their concerns about possible dangers of exercise had decreased, they appreciated how exercise could reduce symptoms (treatment beliefs) and their confidence in their ability to use exercise to effect improvements (exercise self-efficacy) increased. These improvements were attributed to the content and structure of the programme, and the care and guidance of the physiotherapist. Several expressed a need for on-going support.
ESCAPE-knee pain appears to achieve improvements by increasing people's treatment belief in safety and the utility of exercise to control symptoms, rather than alteration in their beliefs about causation or prognosis.
Current Controlled Trials ISRCTN94658828.
探讨慢性膝痛患者的健康信念、经历、治疗和期望，并调查他们在参加基于综合运动的康复计划（通过运动使关节炎性膝痛患者实现自我管理和应对，ESCAPE-knee pain）后，这些信念、经历、治疗和期望是否以及如何发生变化，为什么会发生变化。
在参加该计划之前（n=29）和之后（n=23），对慢性膝痛患者进行了半结构化访谈。使用主题分析来记录人们的基线健康信念、态度和认知，并观察他们在完成该计划后这些信念、态度和认知是否以及如何发生变化，以及为什么会发生变化。
最初，人们对膝关节疼痛的管理或预后的理解和信念较差，且较为消极和宿命论。参加完该计划后，大多数参与者的体验较为积极，描述了疼痛、身体和心理社会功能的改善，对病情和治疗选择的认识和理解有所提高，以及控制症状的运动能力有所提高。对膝关节疼痛的病因和预后的信念没有改变，但他们对运动可能带来的危险的担忧减少了，他们认识到运动可以减轻症状（治疗信念），并对自己运用运动改善状况的能力更有信心（运动自我效能）。这些改善归因于该计划的内容和结构，以及物理治疗师的关怀和指导。一些人表示需要持续的支持。
ESCAPE-knee pain 似乎通过增加人们对运动安全性和控制症状的有效性的治疗信念来实现改善，而不是改变他们对病因或预后的信念。
当前对照试验 ISRCTN94658828。
