腰痛生物心理社会模型的25年——是时候庆祝了吗？第十二届腰痛初级保健研究国际论坛报告
Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain.
作者信息
Pincus Tamar, Kent Peter, Bronfort Gert, Loisel Patrick, Pransky Glenn, Hartvigsen Jan
机构信息
*Department of Psychology, Clinical, Health, and Social Psychology, Royal Holloway, University of London, England, United Kingdom †Research Department, Spine Centre of Southern Denmark, Institute of Regional Health Services Research, Hospital Lillebaelt, University of Southern Denmark, Middelfart, Denmark ‡Musculoskeletal Research Program, Northwestern Health Sciences University, Minnesota §Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark ¶Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada ‖Canadian Memorial Chiropractic College, Toronto, Ontario, Canada **Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts ††Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA ‡‡Harvard School of Public Health, Boston, MA; and §§Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
出版信息
Spine (Phila Pa 1976). 2013 Nov 15;38(24):2118-23. doi: 10.1097/BRS.0b013e3182a8c5d6.
STUDY DESIGN
An integrated review of current knowledge about the biopsychosocial model of back pain for understanding etiology, prognosis, and interventions, as presented at the plenary sessions of the XII International Forum on LBP Research in Primary Care (Denmark; October 17-19, 2012).
OBJECTIVE
To evaluate the utility of the model in reference to rising rates of back pain-related disability, by identifying (a) the most promising avenues for future research in biological, psychological, and social approaches, (b) promising combinations of all 3 approaches, and (c) obstacles to effective implementation of biopsychosocial-based research and clinical practice.
SUMMARY OF BACKGROUND DATA
The biopsychosocial model of back pain has become a dominant model in the conceptualization of the etiology and prognosis of back pain, and has led to the development and testing of many interventions. Despite this back pain remains a leading source of disability worldwide.
METHODS
The review is a synthesis based on the plenary sessions and discussions at the XII International Forum on LBP Research in Primary Care. The presentations included evidence-based reviews of the current state of knowledge in each of the 3 areas (biological, psychological, and social), identification of obstacles to effective implementation and missed opportunities, and identification of the most promising paths for future research.
RESULTS
Although there is good evidence for the role of biological, psychological, and social factors in the etiology and prognosis of back pain, synthesis of the 3 in research and clinical practice has been suboptimal.
CONCLUSION
The utility of the biopsychosocial framework cannot be fully assessed until we truly adopt and apply it in research and clinical practice.
LEVEL OF EVIDENCE
N/A.
研究设计
对有关背痛生物心理社会模型的现有知识进行综合综述，以了解其病因、预后和干预措施，内容来自第十二届基层医疗腰痛研究国际论坛全体会议（丹麦；2012年10月17 - 19日）。
目的
通过确定（a）生物、心理和社会方法未来研究最有前景的途径，（b）所有三种方法的有前景的组合，以及（c）基于生物心理社会的研究和临床实践有效实施的障碍，评估该模型在应对背痛相关残疾率上升方面的效用。
背景数据总结
背痛的生物心理社会模型已成为背痛病因和预后概念化中的主导模型，并促成了许多干预措施的开发和测试。尽管如此，背痛仍是全球残疾的主要原因。
方法
该综述基于第十二届基层医疗腰痛研究国际论坛的全体会议和讨论进行综合。报告内容包括对三个领域（生物、心理和社会）当前知识状态的循证综述、有效实施的障碍和错失机会的识别，以及未来研究最有前景的路径的识别。
结果
虽然有充分证据表明生物、心理和社会因素在背痛病因和预后中起作用，但在研究和临床实践中将三者综合起来的效果并不理想。
结论
在我们真正在研究和临床实践中采用和应用生物心理社会框架之前，无法充分评估其效用。
证据级别
无。
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