Cottrell Elizabeth, Foster Nadine E, Porcheret Mark, Rathod Trishna, Roddy Edward
Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, UK.
Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, UK.
BMJ Open. 2017 Jun 17;7(6):e014999. doi: 10.1136/bmjopen-2016-014999.
The aim of this study was to investigate general practitioners' (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis.
Primary care GPs in the UK.
5000 GPs, randomly selected from Binley's database, were mailed a cross-sectional questionnaire survey.
GPs' attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions. GPs were invited to report barriers experienced when initiating exercise with patients with CKP RESULTS: 835 (17%) GPs responded. Overall, GPs were positive about general exercise for CKP. 729 (87%) reported using exercise, of which, 538 (74%) reported that they would use both general and local (lower limb) exercises. However, only 92 (11% of all responding) GPs reported initiating exercise in ways aligning with best-evidence recommendations. 815 (98%) GPs reported barriers in using exercise for patients with CKP, most commonly, insufficient time in consultations (n=419; 51%) and insufficient expertise (n=337; 41%).
While GPs' attitudes and beliefs regarding exercise for CKP were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported. GPs' use of exercise may be improved by addressing the key barriers of time and expertise, by developing a pragmatic approach that supports GPs to initiate individualised exercise, and/or by other professionals taking on this role.
本研究旨在调查全科医生（GPs）对于为骨关节炎所致慢性膝关节疼痛（CKP）患者使用运动疗法的态度、信念及行为。
英国基层医疗的全科医生。
从宾利数据库中随机选取5000名全科医生，邮寄给他们一份横断面问卷调查。
使用态度陈述调查全科医生的态度和信念，使用基于病例的问题确定所报告的行为。邀请全科医生报告在为CKP患者开始运动疗法时遇到的障碍。结果：835名（17%）全科医生做出回应。总体而言，全科医生对CKP的一般运动疗法持积极态度。729名（87%）报告使用运动疗法，其中，538名（74%）报告他们会同时使用一般运动和局部（下肢）运动。然而，只有92名（占所有回复者的11%）全科医生报告以符合最佳证据推荐的方式开始运动疗法。815名（98%）全科医生报告在为CKP患者使用运动疗法时存在障碍，最常见的是咨询时间不足（n = 419；51%）和专业知识不足（n = 337；41%）。
虽然全科医生对CKP运动疗法的态度和信念总体上是积极的，但运动疗法的开始往往与当前推荐存在较大差距，并且报告了障碍和不确定性。通过解决时间和专业知识的关键障碍、制定支持全科医生开始个体化运动疗法的务实方法，和/或由其他专业人员承担此角色，可能会改善全科医生对运动疗法的使用。
