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慢性下腰痛的目标设定实践。当前的实践情况如何,它是否受到信念和态度的影响?

Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

作者信息

Gardner Tania, Refshauge Kathryn, McAuley James, Hübscher Markus, Goodall Stephen, Smith Lorraine

机构信息

a Faculty of Pharmacy , Sydney University , Sydney , Australia.

b Faculty of Health Sciences , Sydney University , Sydney , Australia.

出版信息

Physiother Theory Pract. 2018 Oct;34(10):795-805. doi: 10.1080/09593985.2018.1425785. Epub 2018 Jan 18.

Abstract

INTRODUCTION

Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice.

METHOD

A cross-sectional observational survey.

RESULTS

The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score.

CONCLUSION

Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

摘要

引言

由患者主导的目标设定作为慢性下腰痛(CLBP)管理的一种有效治疗方法具有广阔前景;然而,目前对此实践了解甚少。本研究的目的是探讨:(1)物理治疗师对CLBP进行目标设定的当前实践情况;(2)CLBP目标设定中可感知的障碍;以及(3)临床医生的态度和信念与目标设定实践之间的关系。

方法

横断面观察性调查。

结果

大多数受访者进行目标设定的主要目的是促进自我管理。设定目标时,治疗师与患者参与度各占50%的情况最为常见。目标设定中最常被感知到的障碍与时间限制以及缺乏技能和信心有关。治疗师以生物医学为导向的治疗得分越高,患者参与度得分越低。

结论

目标设定是CLBP的常见做法,且被视为高度优先事项。它更多地是治疗师与患者之间的协作,而非患者主导,物理治疗师的治疗导向是患者参与度的一个预测因素。医疗保健专业人员的教育需要包括对慢性疼痛的更好理解,以使他们摆脱生物医学治疗方法,同时提高促进患者参与目标设定的技能。

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