J. Waterfield, EdD, MSc, School of Health and Rehabilitation and Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom.
B. Bartlam, PhD, MA, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University.
Phys Ther. 2015 Sep;95(9):1234-43. doi: 10.2522/ptj.20140298. Epub 2015 Apr 30.
Low back pain is often accepted as a "normal" part of pregnancy. Despite research suggesting that quality of life for women who are pregnant is adversely affected, most are advised to self-manage. Although the use of acupuncture for the management of persistent nonspecific low back pain has been recommended in recent UK national guidelines, its use in the management of pregnancy-related low back pain remains limited.
This study aimed to explore the perceptions and experiences of physical therapists involved in treating women who are pregnant and have low back pain with the objective of informing the pretrial training program for a pilot randomized trial (Evaluating Acupuncture and Standard care for pregnant womEn with Back pain [EASE Back]).
A qualitative phenomenological method with purposive sampling was used in the study.
Three focus groups and 3 individual semistructured interviews were undertaken, and an iterative exploratory thematic analysis was performed. To ensure transparency of the research process and the decisions made, an audit trail was created.
Twenty-one physical therapists participated, and emergent issues included: a lack of experience in treating pregnancy-related complaints, mixed messages from previous acupuncture education, a mistrust of the current evidence for acupuncture safety and effectiveness, and personal and professional fear of causing harm.
The findings suggest that UK physical therapists are reluctant to use acupuncture in the management of pregnancy-related low back pain. The explanations for these findings include perceived lack of knowledge and confidence, as well as a pervasive professional culture of caution, particularly fears of inducing early labor and of litigation. These findings have been key to informing the content of the training program for physical therapists delivering acupuncture within the pilot EASE Back trial.
下背痛常被认为是妊娠的“正常”现象。尽管有研究表明，妊娠女性的生活质量受到了负面影响，但大多数人仍被建议自我管理。尽管英国国家指南最近建议将针灸用于治疗持续性非特异性下背痛，但在妊娠相关性下背痛的管理中，其应用仍有限。
本研究旨在探讨参与治疗妊娠伴下背痛的物理治疗师的认知和体验，旨在为一项先导随机试验（Evaluating Acupuncture and Standard care for pregnant womEn with Back pain [EASE Back]）的预试验培训计划提供信息。
本研究采用了有目的抽样的定性现象学方法。
进行了 3 次焦点小组和 3 次个别半结构化访谈，并进行了迭代探索性主题分析。为了确保研究过程和决策的透明度，创建了一个审核跟踪。
21 名物理治疗师参与了研究，出现的问题包括：缺乏治疗妊娠相关疾病的经验、之前的针灸教育信息混杂、对当前针灸安全性和有效性证据的不信任、个人和专业对造成伤害的恐惧。
研究结果表明，英国物理治疗师不愿意在妊娠相关性下背痛的管理中使用针灸。这些发现的解释包括感知到的缺乏知识和信心，以及普遍存在的谨慎专业文化，特别是对诱发早产和诉讼的担忧。这些发现为在先导性 EASE Back 试验中提供针灸治疗的物理治疗师培训计划的内容提供了关键信息。
