Patel Geeta, Walsh Nicola, Gooberman-Hill Rachael
Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
Musculoskeletal Care. 2014 Dec;12(4):199-209. doi: 10.1002/msc.1074. Epub 2014 May 19.
Osteoarthritis (OA) is one of the most common musculoskeletal conditions and a major cause of chronic pain and disability. Self-management of OA through education and exercise are recommended as core treatments. Current research has demonstrated the effectiveness of these approaches, but most trials tailor interventions for specific joints. The aim of the present study was to explore healthcare professionals' views on a group-based exercise intervention designed to facilitate the self-management of OA in the lower limbs and/or lower back.
Individual semi-structured interviews were conducted with 20 healthcare professionals (nine general practitioners, ten physiotherapists and one community-based rheumatologist). The interviews were audio-recorded, transcribed and analysed using thematic analysis.
Three themes were identified: 1) Patient understanding of osteoarthritis; 2) Multiple-joint approach and 3) Practical aspects of the intervention. Healthcare professionals stated the usefulness of the intervention in improving patients' knowledge about their condition and self-management. They commented on including patients affected with OA in multiple or different lower limb sites in the intervention. They considered this a positive move, as they viewed self-management techniques as applicable to more than one affected joint in the lower body. Consideration of the practical aspects of the intervention included thoughts on an appropriate facilitator, the need to ensure accessibility to patients and ways to exercise once the intervention had ended.
Healthcare professionals saw the intervention as an acceptable and feasible approach to facilitate the self-management of OA. This study has implications for developing and implementing cost-effective interventions in primary care settings.
骨关节炎(OA)是最常见的肌肉骨骼疾病之一,也是慢性疼痛和残疾的主要原因。通过教育和锻炼进行骨关节炎的自我管理被推荐为核心治疗方法。目前的研究已经证明了这些方法的有效性,但大多数试验针对特定关节定制干预措施。本研究的目的是探讨医疗保健专业人员对一种旨在促进下肢和/或下背部骨关节炎自我管理的团体运动干预措施的看法。
对20名医疗保健专业人员(9名全科医生、10名物理治疗师和1名社区风湿病学家)进行了个人半结构化访谈。访谈进行了录音、转录,并使用主题分析法进行分析。
确定了三个主题:1)患者对骨关节炎的理解;2)多关节方法;3)干预措施的实际方面。医疗保健专业人员表示,该干预措施有助于提高患者对自身病情和自我管理的认识。他们对将多个或不同下肢部位受骨关节炎影响的患者纳入干预措施发表了评论。他们认为这是一个积极的举措,因为他们认为自我管理技术适用于下半身多个受影响的关节。对干预措施实际方面的考虑包括对合适的促进者的想法、确保患者能够参与的必要性以及干预结束后锻炼的方式。
医疗保健专业人员认为该干预措施是促进骨关节炎自我管理的一种可接受且可行的方法。本研究对在初级保健环境中开发和实施具有成本效益的干预措施具有启示意义。