魁北克物理治疗师对腰痛的管理：我们做得如何？
Management of low back pain by physical therapists in quebec: how are we doing?
作者信息
Derghazarian Tamar, Simmonds Maureen J
机构信息
School of Physical and Occupational Therapy, McGill University, Montreal, QC.
出版信息
Physiother Can. 2011 Fall;63(4):464-73. doi: 10.3138/ptc.2010-04P. Epub 2011 Oct 20.
Abstract
PURPOSE
In this study, we characterized physiotherapists' attitudes and beliefs about the bio-psychosocial problem of low back pain (LBP), their use of clinical practice guidelines (CPGs), and the extent to which their advice and treatment is in line with best-evidence CPGs.
METHODS
One hundred eight physiotherapists completed an online survey that included questionnaires exploring the strength of physiotherapists' biomedical and bio-psychosocial orientations toward the management of LBP: the Pain Attitudes and Beliefs Scale for Physiotherapists and the Attitudes to Back Pain Scale for musculoskeletal practitioners. In addition, participants responded to questions about treatment recommendations for patients in two vignettes.
RESULTS
Only 12% of respondents were aware of CPGs. Physiotherapists with a stronger biomedical orientation scored the severity of spinal pathology higher in the patient vignettes. A stronger biomedical orientation was also associated with disagreement with recommendations to return to usual activity or work.
CONCLUSIONS
The results suggest limited awareness by physiotherapists of best-evidence CPGs and contemporary understandings of LBP that support early activation and self-management. Research to better understand and facilitate the implementation of best-evidence professional education and clinical practice is an urgent priority.
摘要
目的
在本研究中，我们对物理治疗师关于腰痛（LBP）生物心理社会问题的态度和信念、他们对临床实践指南（CPG）的使用，以及他们的建议和治疗与最佳证据CPG的符合程度进行了特征描述。
方法
108名物理治疗师完成了一项在线调查，其中包括一些问卷，用以探究物理治疗师在管理LBP方面生物医学和生物心理社会取向的程度：物理治疗师疼痛态度和信念量表以及肌肉骨骼从业者背痛态度量表。此外，参与者对两个案例中患者的治疗建议问题进行了回答。
结果
只有12%的受访者知晓CPG。在案例中，具有更强生物医学取向的物理治疗师对脊柱病理严重程度的评分更高。更强的生物医学取向还与不同意恢复日常活动或工作的建议相关。
结论
结果表明物理治疗师对最佳证据CPG以及支持早期活动和自我管理的LBP当代理解的认识有限。开展研究以更好地理解并促进最佳证据专业教育和临床实践的实施是当务之急。
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2
An interdisciplinary guideline development process: the Clinic on Low-back pain in Interdisciplinary Practice (CLIP) low-back pain guidelines.跨学科指南制定流程：CLIP（跨学科实践下腰痛诊所）腰痛指南。
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3
Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society.腰痛的诊断与治疗：美国医师学会和美国疼痛协会联合临床实践指南
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4
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5
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6
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7
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8
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9
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10
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