Tan B-K, Smith Anne J, O'Sullivan Peter B, Chen Gang, Burnett Angus F, Briggs Andrew M
International Health, School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia 6845, Australia.
BMC Musculoskelet Disord. 2014 Jul 28;15:255. doi: 10.1186/1471-2474-15-255.
Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge gap among these relationships in non-western countries. The aim of this study was to examine the associations between LBP-related beliefs among Chinese HCPs and characteristics of these HCPs.
A convenience sample of 432 HCPs working in various health settings in Shanghai, China, completed a series of questionnaires assessing their demographic characteristics, LBP status, pain-related disability and their beliefs about their own LBP experience, using the Back beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ).
Younger Chinese HCPs (20-29 years) held more negative beliefs and attitudes related to LBP compared to older HCPs (>40years; BBQ mean difference [95% CI]: 2.4 [0.9 - 3.9], p = 0.001). HCPs working outside tertiary hospitals had poorer beliefs concerning the inevitable consequences of LBP (BBQ mean difference [95% CI]: -2.4 [-3.8 - -1.0], p = 0.001). HCPs who experienced LBP had higher level of fear avoidance beliefs when experiencing high LBP-related disability (FABQ-physical mean difference [95% CI]: 2.8 [1.5 - 4.1], p < 0.001; FABQ-work mean difference [95% CI]: 6.2 [4.0 - 8.4], p < 0.001)) and had lower level of fear avoidance beliefs if they had completed postgraduate study (FABQ-physical mean difference [95% CI]: 2.9 [-5.8 - 0.0], p = 0.049).
This study suggests that LBP-related beliefs and attitudes among Chinese HCPs are influenced by age, location of work, level of LBP-related disability and education level. Understanding back pain beliefs of Chinese HCPs forms an important foundation for future studies into the condition and its management in China.
腰痛是全球致残的主要原因。有证据表明，采用生物心理社会方法进行腰痛管理的更有效护理模式，凸显了了解患者及其治疗者与疼痛相关信念的必要性。已知医疗保健专业人员（HCPs）的信念会影响给予患者的治疗建议，进而影响管理结果。已知背痛信念会受到文化、教育、健康素养、工作地点、腰痛个人经历以及腰痛后遗症（如残疾）等因素的影响。目前在非西方国家，这些关系方面存在知识空白。本研究的目的是探讨中国医疗保健专业人员中与腰痛相关信念之间的关联以及这些专业人员的特征。
对在中国上海不同医疗机构工作的432名医疗保健专业人员进行便利抽样，他们使用背痛信念问卷（BBQ）和恐惧回避信念问卷（FABQ）完成了一系列问卷，评估其人口统计学特征、腰痛状况、与疼痛相关的残疾情况以及他们对自身腰痛经历的信念。
与年龄较大的医疗保健专业人员（>40岁）相比，年龄较小的中国医疗保健专业人员（20 - 29岁）对腰痛持有更多负面信念和态度（BBQ平均差异[95%置信区间]：2.4[0.9 - 3.9]，p = 0.001）。在三级医院以外工作的医疗保健专业人员对腰痛不可避免后果的信念较差（BBQ平均差异[95%置信区间]：-2.4[-3.8 - -1.0]，p = 0.001）。经历过腰痛的医疗保健专业人员在与腰痛相关的残疾程度较高时，恐惧回避信念水平较高（FABQ - 身体平均差异[95%置信区间]：2.8[1.5 - 4.1]，p < 0.001；FABQ - 工作平均差异[95%置信区间]：6.2[4.0 - 8.4]，p < 0.001），而如果他们完成了研究生学习，则恐惧回避信念水平较低（FABQ - 身体平均差异[95%置信区间]：2.9[-5.8 - 0.0]，p = 0.049）。
本研究表明，中国医疗保健专业人员中与腰痛相关的信念和态度受年龄、工作地点、与腰痛相关的残疾程度和教育水平的影响。了解中国医疗保健专业人员的背痛信念为未来中国对该病症及其管理的研究奠定了重要基础。
