Service de médecine physique et de réadaptation, centre hospitalier Jacques-Lacarin, 03100 Vichy, France.
Université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service de médecine physique et de réadaptation, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France.
Ann Phys Rehabil Med. 2017 Apr;60(2):68-73. doi: 10.1016/j.rehab.2015.10.008. Epub 2016 Jan 6.
We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy.
In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires.
At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008).
Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS.
NCT00761111.
我们旨在评估整合慢性疼痛管理的生物心理社会模型的小册子对减少接受腰椎间盘切除术的患者残疾的影响。
在一项前瞻性、对照、时间序列研究中,我们采用交替月份设计,在一家三级护理大学医院首次接受单纯腰椎间盘切除术的 129 名患者中进行了研究。干预组接受生物心理社会循证小册子,对照组接受生物医学小册子;小册子仅在信息内容上有所不同。患者对治疗组不知情。主要结局是术后 2 个月的残疾(用魁北克腰痛残疾量表[QBPDS]衡量)。次要结局是用恐惧-回避信念量表(FABQ)测量的恐惧和回避信念。所有数据均通过自我报告问卷收集。
在 2 个月时,两组之间的残疾没有差异(QBPDS 评分 32.4±22.8 与 36.1±18.7,P=0.36)。与对照组相比,基于证据的小册子的 FABQ 体力活动评分较低(8.0±7.14 与 11.2±6.3,P=0.008)。
在手术后 2 个月时,提供基于证据的小册子对残疾没有影响,但减少了对体力活动的恐惧-回避信念。这本小册子可能是医疗保健专业人员帮助患者教育的有效工具。临床试验.gov 标识符:NCT00761111。