Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand.
Disabil Rehabil. 2010;32(20):1645-57. doi: 10.3109/09638281003649896.
This study explored experiences of receiving treatment for musculoskeletal pain (MSKP), particularly choices of complementary and alternative medicine (CAM) and/or conventional treatment, using the illness perception dimension of Leventhal's Self-Regulatory Model as the underpinning model within the broader biopsychosocial framework of the International Classification of Functioning, Disability and Health.
A mixed-method study was conducted involving 17 people with MSKP. Data were collected in semi-structured interviews, using a phased approach that included the Brief Illness Perception Questionnaire and open-ended questions about experiences of managing and seeking treatment for MSKP. Questionnaire data were analysed descriptively; interview data were transcribed verbatim and analysed using the principles of Interpretative Phenomenological Analysis.
Analysis points to health professionals and participants as gatekeepers to treatment, with gatekeeping based on matters of power, searching for solutions, and managing day to day. The themes Role of the Gatekeeper, Swing of the Interminable Pendulum, and Solution of Soldiering On are discussed in relation to literature about health beliefs and choices of CAM or conventional treatments.
Future research could include mixed-method designs to further explore issues of knowledge, beliefs, and control that feed into the role of gatekeepers to treatment, as well as comparing CAM choices between public and privately-funded healthcare.
本研究旨在探索肌肉骨骼疼痛(MSKP)患者的治疗体验,特别是在更广泛的国际功能、残疾和健康分类的生物心理社会框架内,以 Leventhal 自我调节模型的疾病感知维度为基础,选择补充和替代医学(CAM)和/或常规治疗。
本混合方法研究纳入了 17 名 MSKP 患者。采用分阶段方法收集半结构化访谈数据,包括简要疾病感知问卷和关于管理和寻求 MSKP 治疗的开放性问题。问卷数据进行描述性分析;访谈数据逐字转录,并使用解释现象学分析的原则进行分析。
分析指出,医疗保健专业人员和参与者是治疗的守门人,守门人基于权力、寻找解决方案和日常管理等因素。讨论了主题“守门人的角色”、“无休止摆动的钟摆”和“坚持不懈的解决方案”,这些主题与健康信念和 CAM 或常规治疗选择的文献有关。
未来的研究可以包括混合方法设计,以进一步探讨影响治疗守门人角色的知识、信仰和控制问题,以及比较公共和私人资助的医疗保健之间的 CAM 选择。