一项旨在改善非特异性下背痛患者背部相关认知的多媒体宣传活动：过程评估
A multimedia campaign to improve back beliefs in patients with non-specific low back pain: a process evaluation.
作者信息
Suman Arnela, Schaafsma Frederieke G, Bamarni Jiman, van Tulder Maurits W, Anema Johannes R
机构信息
Amsterdam Public Health research institute, Department of Public and Occupational Health, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Department of Public and Occupational Health, Research Centre for Insurance Medicine, Collaboration between AMC-UMCG-UWV-VUmc, VU University medical centre, PO Box 7067, 1007 MB, Amsterdam, The Netherlands.
出版信息
BMC Musculoskelet Disord. 2017 May 18;18(1):200. doi: 10.1186/s12891-017-1551-z.
BACKGROUND
Low back pain (LBP) is one of the most prevalent and costly disorders worldwide. To reduce its burden in the Netherlands, implementation of a multidisciplinary guideline for LBP was supported by a multifaceted eHealth campaign for patients with LBP. The current study aims 1) to evaluate whether the implementation strategy was performed as planned; 2) to assess the feasibility, barriers and facilitators of the patient based eHealth campaign; 3) to gain insight into the satisfaction and experiences of patients with various ethnic backgrounds with the implementation strategy and to make a comparison between them; and 4) to explore the association between exposure to and satisfaction with the implementation strategy.
METHODS
This process evaluation was performed using the Linnan and Steckler framework, and used a mixed methods approach for data collection and analysis. The relationship between satisfaction of patients and exposure to the strategy was statistically examined. Semi-structured interviews were analysed using qualitative data analysis methods.
RESULTS
Two hundred and fourteen patients participated in the quantitative, and 44 in the qualitative analysis. Most were female and had a high level of education. Many patients did not use the campaign at all or only once, and those that did rated it as reasonable. Patient satisfaction with the campaign increased significantly with an increase in its use. Qualitative analysis showed that four main themes played a role in campaign rating and use: satisfaction with intervention components, perceived benefits of the intervention, usage of the intervention, and satisfaction with the medium used.
CONCLUSION
This process evaluation showed that the eHealth campaign was used only by a small proportion of patients with non-specific LBP. It seemed that the campaign was offered to the patients too late, that the lay-out of the campaign did not meet patient needs, and that healthcare providers rarely discussed the campaign with their patients, while involvement of those providers seemed to improve trustworthiness of the campaign and increase its usage. It is important to invest effort into healthcare providers to motivate patients to use eHealth intervention and to tailor strategies better to the needs of users.
TRIAL REGISTRATION
Netherlands Trial Register (NTR): NTR4329 . Registered December 20th, 2013.
背景
腰痛（LBP）是全球最常见且成本高昂的疾病之一。为减轻其在荷兰的负担，针对LBP的多学科指南的实施得到了一项针对LBP患者的多方面电子健康运动的支持。本研究旨在：1）评估实施策略是否按计划执行；2）评估基于患者的电子健康运动的可行性、障碍和促进因素；3）深入了解不同种族背景患者对实施策略的满意度和体验，并进行比较；4）探索接触实施策略与对其满意度之间的关联。
方法
本过程评估采用林南和斯特克勒框架，并使用混合方法进行数据收集和分析。对患者满意度与接触策略之间的关系进行了统计学检验。使用定性数据分析方法对半结构化访谈进行分析。
结果
214名患者参与了定量分析，44名患者参与了定性分析。大多数为女性，且教育程度较高。许多患者根本未使用该运动或仅使用过一次，使用过的患者对其评价为一般。患者对运动的满意度随着使用次数的增加而显著提高。定性分析表明，有四个主要主题在运动评价和使用中发挥了作用：对干预组成部分的满意度、对干预的感知益处、干预的使用情况以及对所使用媒介的满意度。
结论
本过程评估表明，只有一小部分非特异性LBP患者使用了电子健康运动。似乎该运动向患者提供得太晚，运动的布局不符合患者需求，且医疗保健提供者很少与患者讨论该运动，而这些提供者的参与似乎能提高运动的可信度并增加其使用率。投入精力促使医疗保健提供者激励患者使用电子健康干预措施并更好地根据用户需求调整策略非常重要。
试验注册
荷兰试验注册库（NTR）：NTR4329。于2013年12月20日注册。
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