Interdisciplinary Persistent Pain Centre, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
Occupational Therapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Pain. 2018 Oct;159(10):2128-2136. doi: 10.1097/j.pain.0000000000001285.
Beyond expert suggestions as to the appropriate subject matter for chronic pain assessments, little is known about the actual content of multidisciplinary pain centre (MPC) clinical assessments. The International Classification of Functioning, Disability and Health Low Back Pain Core Set (ICF LBP-CS) provides a universal language to support the consistent description of LBP-related assessments across disciplines within multidisciplinary teams (MDTs). This study sought to map the content of MPC clinical assessments to the ICF to: (1) identify and compare the content of clinical MDT assessments using a cross-disciplinary framework and (2) examine the content validity of the LBP-CS. A qualitative examination of MPC team clinical assessments of chronic low back pain was undertaken. Multidisciplinary team (pain medicine, psychiatry, nursing, physiotherapy, occupational therapy, and psychology) assessments were audio-recorded and transcribed. Concepts were extracted from transcripts using a meaning condensation procedure and then linked to the ICF. Across 7 MDT assessments, comprised 42 discipline-specific assessments and 241,209 transcribed words, 8596 concepts were extracted. Contextual factors (ie, the person and environment), except for physiotherapy, accounted for almost half of each discipline's assessments (range: 49%-58%). Concepts spanned 113 second-level ICF categories, including 73/78 LBP-CS categories. Overall, the findings revealed novel insights into the content of MPC clinical assessments that can be used to improve health care delivery. International Classification of Functioning, Disability and Health-based assessment profiles demonstrated unique contributions from each discipline to chronic low back pain assessment. Finally, users of the LBP-CS can be confident that the tool exhibits sound content validity from the perceptive of MDT assessments of functioning, disability, and health.
除了专家对慢性疼痛评估的适当主题的建议之外，对于多学科疼痛中心（MPC）临床评估的实际内容知之甚少。国际功能、残疾和健康分类慢性腰痛核心集（ICF LBP-CS）为跨学科团队（MDT）内的不同学科提供了一致描述与腰痛相关评估的通用语言。本研究旨在将 MPC 临床评估的内容映射到 ICF 上，以：（1）使用跨学科框架识别和比较 MDT 评估的内容；（2）检验 LBP-CS 的内容效度。对 MPC 团队对慢性下腰痛的临床评估进行了定性检查。对多学科团队（疼痛医学、精神病学、护理、物理治疗、职业治疗和心理学）的评估进行了录音和转录。使用意义浓缩程序从记录中提取概念，然后将其与 ICF 联系起来。在 7 次 MDT 评估中，包括 42 项专科评估和 241,209 个转录单词，共提取了 8596 个概念。除了物理治疗外，环境因素（即人与环境）几乎占每个学科评估的一半（范围：49%-58%）。概念涵盖了 113 个二级 ICF 类别，包括 78 个 LBP-CS 类别中的 73 个。总体而言，这些发现揭示了 MPC 临床评估内容的新见解，可用于改善医疗保健服务。基于国际功能、残疾和健康评估的档案显示，每个学科对慢性腰痛评估都有独特的贡献。最后，LBP-CS 的使用者可以相信，从 MDT 对功能、残疾和健康的评估来看，该工具具有良好的内容效度。
