The Sahlgrenska Academy, University of Gothenburg Institute of Neuroscience and Physiology/Physiotherapy, Gothenburg, Sweden.
Physiother Theory Pract. 2010 Jul;26(5):308-17. doi: 10.3109/09593980903082136.
Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.
肌肉骨骼疾病普遍存在，给个人和社会带来了沉重负担。关于患者参与度和对结果的责任感之间关系的信息有限。本研究旨在探讨肌肉骨骼疾病患者自我报告的物理治疗效果与对疾病责任态度之间的关系。采用了横断面邮寄问卷调查设计。从一家门诊物理治疗诊所招募了 615 名在过去 6 个月内完成物理治疗的患者，向他们发送了一份包括肌肉骨骼疾病责任态度量表（ARM）、自我报告的治疗效果和社会人口统计学数据的问卷。共收回 279 份（45%）完成的问卷。采用多变量逻辑回归分析。在控制了年龄、性别、教育程度、体力活动以及治疗次数、主要治疗和物理治疗师后，患者在 ARM 的四个维度（“自我积极责任”、“责任不在我”、“雇主责任”和“医疗专业人员责任”）上的得分与患者自我报告的治疗效果相关。将责任更多归因于自己的患者更有可能（OR 2.37 及以上）报告物理治疗效果显著改善。由于本研究仅在一家物理治疗门诊诊所进行，且采用横断面设计，因此需要在其他环境中复制这些结果。由于患者对肌肉骨骼疾病责任的态度可能会影响物理治疗的效果，因此决定是否有系统地尝试影响患者对疾病管理的责任态度，或者根据态度来匹配治疗可能会有所帮助。
