Synnott Aoife, O'Keeffe Mary, Bunzli Samantha, Dankaerts Wim, O'Sullivan Peter, O'Sullivan Kieran
Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
School of Physiotherapy, Curtin University, Perth, Australia.
J Physiother. 2015 Apr;61(2):68-76. doi: 10.1016/j.jphys.2015.02.016. Epub 2015 Mar 23.
What are physiotherapists' perceptions about identifying and managing the cognitive, psychological and social factors that may act as barriers to recovery for people with low back pain (LBP)?
Systematic review and qualitative metasynthesis of qualitative studies in which physiotherapists were questioned, using focus groups or semi-structured interviews, about identifying and managing cognitive, psychological and social factors in people with LBP.
Qualified physiotherapists with experience in treating patients with LBP.
Studies were synthesised in narrative format and thematic analysis was used to provide a collective insight into the physiotherapists' perceptions.
Three main themes emerged: physiotherapists only partially recognised cognitive, psychological and social factors in LBP, with most discussion around factors such as family, work and unhelpful patient expectations; some physiotherapists stigmatised patients with LBP as demanding, attention-seeking and poorly motivated when they presented with behaviours suggestive of these factors; and physiotherapists questioned the relevance of screening for these factors because they were perceived to extend beyond their scope of practice, with many feeling under-skilled in addressing them.
Physiotherapists partially recognised cognitive, psychological and social factors in people with LBP. Physiotherapists expressed a preference for dealing with the more mechanical aspects of LBP, and some stigmatised the behaviours suggestive of cognitive, psychological and social contributions to LBP. Physiotherapists perceived that neither their initial training, nor currently available professional development training, instilled them with the requisite skills and confidence to successfully address and treat the multidimensional pain presentations seen in LBP.
CRD 42014009964. [Synnott A, O'Keeffe M, Bunzli S, Dankaerts W, O'Sullivan P, O'Sullivan K (2015) Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review.Journal of Physiotherapy61: 68-76].
物理治疗师对于识别和处理那些可能成为腰痛（LBP）患者康复障碍的认知、心理和社会因素有哪些看法？
对定性研究进行系统综述和定性元分析，这些定性研究通过焦点小组或半结构式访谈，就物理治疗师对腰痛患者认知、心理和社会因素的识别与处理进行询问。
有治疗腰痛患者经验的合格物理治疗师。
研究以叙述形式进行综合，并采用主题分析以深入了解物理治疗师的看法。
出现了三个主要主题：物理治疗师仅部分认识到腰痛中的认知、心理和社会因素，大多数讨论围绕家庭、工作和患者无益期望等因素展开；一些物理治疗师将表现出这些因素相关行为的腰痛患者污名化为要求过高、寻求关注和动机不足；物理治疗师质疑筛查这些因素的相关性，因为他们认为这超出了其执业范围，许多人觉得自己在处理这些因素方面技能不足。
物理治疗师部分认识到腰痛患者的认知、心理和社会因素。物理治疗师表示更倾向于处理腰痛中更具机械性的方面，一些人还污名化了那些表明认知、心理和社会因素对腰痛有影响的行为。物理治疗师认为，无论是他们的初始培训，还是目前可得的专业发展培训，都没有赋予他们成功应对和治疗腰痛中所见多维度疼痛表现所需的技能和信心。
CRD 42014009964。[辛诺特A，奥基夫M，邦兹利S，丹卡尔茨W，奥沙利文P，奥沙利文K（2015年）物理治疗师可能会污名化或觉得没有准备好治疗患有腰痛以及有影响康复的心理社会因素的患者：一项系统综述。《物理治疗杂志》61：68 - 76]
