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一项评估慢性下背痛患者治疗偏好的横断面研究。

A Cross-Sectional Study Assessing Treatment Preference of People With Chronic Low Back Pain.

机构信息

Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO.

Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO; Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

出版信息

Arch Phys Med Rehabil. 2018 Dec;99(12):2496-2503. doi: 10.1016/j.apmr.2018.04.027. Epub 2018 May 28.

DOI:10.1016/j.apmr.2018.04.027
PMID:29852151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6650271/
Abstract

OBJECTIVE

To assess treatment preference and attributes of 2 exercise-based treatments for people with chronic low back pain (LBP).

DESIGN

Cross-sectional study.

SETTING

Academic research setting.

PARTICIPANTS

Individuals (N=154) with chronic LBP.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Participants completed a treatment preference assessment (TPA) measure that described 2 treatments for chronic LBP (strength and flexibility [SF] and motor skill training [MST]). Participants rated each treatment on 4 attributes: effectiveness, acceptability/logicality, suitability/appropriateness, and convenience. An overall score for each treatment was calculated as the mean of the 4 attribute ratings. The participants indicated either (1) no treatment preference or (2) preference for SF or MST.

RESULTS

One hundred four participants (67.5%) had a treatment preference; of those, 95 (91.3%) preferred SF and 9 (8.7%) preferred MST. The SF preference group rated SF higher than MST overall and on all attributes (all Ps <.01, ds ranged from .48-1.07). The MST preference group did not rate the treatments differently overall or on any of the attributes (all Ps >.05, ds ranged from .43-.66). Convenience of SF (P=.05, d=.79) and effectiveness (d=1.20), acceptability/logicality (d=1.27), and suitability/appropriateness (d=1.52) of MST (all Ps <.01) were rated differently between the 2 preference groups.

CONCLUSIONS

When presented with 2 treatment options, a majority of patients preferred SF over MST. Convenience was a particularly important attribute affecting preference. Assessing treatment preference and attributes prior to treatment initiation allows the clinician to identify factors that may need to be addressed to enhance adherence to, and outcomes of, treatment.

摘要

目的

评估 2 种基于运动的治疗方法在慢性下背痛(LBP)患者中的治疗偏好和属性。

设计

横断面研究。

设置

学术研究环境。

参与者

慢性 LBP 患者(N=154)。

干预措施

不适用。

主要观察指标

参与者完成了一项治疗偏好评估(TPA)量表,该量表描述了 2 种治疗慢性 LBP 的方法(力量和灵活性[SF]和运动技能训练[MST])。参与者对每种治疗方法的 4 种属性进行了评分:有效性、可接受性/逻辑性、适宜性/适当性和便利性。每种治疗方法的总体评分是 4 种属性评分的平均值。参与者表示要么(1)没有治疗偏好,要么(2)更喜欢 SF 或 MST。

结果

104 名参与者(67.5%)有治疗偏好;其中,95 名(91.3%)更喜欢 SF,9 名(8.7%)更喜欢 MST。SF 偏好组总体上和在所有属性上都对 SF 的评分高于 MST(均 P<.01,ds 范围为.48-1.07)。MST 偏好组在总体上和任何属性上对治疗方法的评分都没有差异(均 P>.05,ds 范围为.43-.66)。SF 的便利性(P=.05,d=.79)、有效性(d=1.20)、可接受性/逻辑性(d=1.27)和适宜性/适当性(d=1.52)在 2 个偏好组之间存在差异。

结论

当提供 2 种治疗选择时,大多数患者更喜欢 SF 而不是 MST。便利性是影响偏好的一个特别重要的属性。在开始治疗前评估治疗偏好和属性可以帮助临床医生确定需要解决的因素,以增强对治疗的依从性和治疗效果。

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