Jacobs Clair M, Guildford Beth J, Travers Warren, Davies Megan, McCracken Lance M
INPUT Pain Management Unit, St Thomas' Hospital, London, UK.
INPUT Pain Management Unit, St Thomas' Hospital, London, UK; King's College London, London, UK.
Br J Pain. 2016 Feb;10(1):38-45. doi: 10.1177/2049463715600460. Epub 2015 Sep 23.
This study aimed to investigate the impact of a brief psychologically informed physiotherapy training (PIPT) course on physiotherapists' attitudes and beliefs towards working with people with chronic pain. Specifically, the training aimed to help the participants better recognise the role of psychosocial factors in chronic pain and to better target the key processes of the psychological flexibility (PF) model in their treatment interactions. A total of 26 physiotherapists working in an outpatient musculoskeletal (MSK) department participated in the 7-hour training session. A total of 25 participants completed self-report questionnaires on attitudes and beliefs, burnout and PF-relevant processes pre- and post-training. The pre- and post-measures were completed on the day of training. PIPT was associated with significant changes in the expected direction in physiotherapists' attitudes towards treatment of people with chronic pain, including a moderate effect size on the Health Care Provider-Pain and Impairment Relationship Scale (HC-PAIRS) (decreased biomedical scores) and a large effect size on the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) (increased biopsychosocial scores and decreased biomedical scores). In conclusion, brief PIPT could help physiotherapists working in non-specialist centres with complex patients, many of whom present with significant emotional distress and pain-related disability. Further research is required to determine whether the changes in attitudes detected in this study translate into clinical practice and whether changes are maintained over a follow-up period.
本研究旨在调查简短的心理知情物理治疗培训(PIPT)课程对物理治疗师针对慢性疼痛患者工作的态度和信念的影响。具体而言,该培训旨在帮助参与者更好地认识心理社会因素在慢性疼痛中的作用,并在其治疗互动中更好地针对心理灵活性(PF)模型的关键过程。共有26名在门诊肌肉骨骼(MSK)科室工作的物理治疗师参加了为期7小时的培训课程。共有25名参与者在培训前后完成了关于态度和信念、倦怠以及与PF相关过程的自我报告问卷。在培训当天完成了前后测量。PIPT与物理治疗师对慢性疼痛患者治疗态度在预期方向上的显著变化相关,包括对医疗保健提供者-疼痛与损伤关系量表(HC-PAIRS)有中等效应量(生物医学得分降低),对物理治疗师疼痛态度和信念量表(PABS-PT)有大效应量(生物心理社会得分增加且生物医学得分降低)。总之,简短的PIPT可以帮助在非专科中心治疗复杂患者的物理治疗师,其中许多患者存在明显的情绪困扰和与疼痛相关的残疾。需要进一步研究以确定本研究中检测到的态度变化是否转化为临床实践,以及这些变化在随访期间是否得以维持。