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芬兰物理治疗疼痛课程:一项教师调查。

Physiotherapy pain curricula in Finland: a faculty survey.

作者信息

Ehrström Jolanda, Kettunen Jyrki, Salo Petri

机构信息

Åbo Akademi University, Faculty of Education and Welfare Studies, Vaasa, Finland.

Fysios FTK Töölö, Urheilukatu 38 A, 00250 Helsinki, Finland, Tel.: +358 50 531 8635.

出版信息

Scand J Pain. 2018 Oct 25;18(4):593-601. doi: 10.1515/sjpain-2018-0091.

Abstract

Background and aims Despite the recognition of pain as a global health problem and advancements achieved in what is known about effective pain management, pain education for undergraduate health care professionals remains insufficient. This study investigated the content of pain curricula and the time allocated to pain education on physiotherapy programs at bachelor's level at Universities of Applied Sciences (UASs) in Finland. Methods A web-based survey questionnaire was sent to the directors of the physiotherapy programs at all the Finnish UASs (n=15) where physiotherapy is taught at bachelor's level. The questionnaire consisted of 14 questions covering basic concepts and the science of pain, pain assessment, pain management, and the adequacy of pain curricula. Each UAS completed one questionnaire i.e. returned one official opinion. Results The response rate was 80% (n=12). The mean for the total number of contact hours of pain education was 74 (standard deviation 34.2). All UASs had integrated pain education. In addition to this 42% (n=5) of the UASs had a separate pain course. The UASs offering such a course over and above the integrated pain education had twice the amount of pain content education compared to those UASs that only had integrated pain education (mean 103 h vs. 53 h, p=0.0043). Most of the education was devoted to conditions where pain is commonly a feature, manual therapy, and electrical agents for pain control. The biopsychosocial model of pain, cognitive behavioral methods of pain management, physician management, and multidisciplinary management were the least covered topics. Five UASs (42%) payed attention to the International Association for the Study of Pain curriculum outline and only 33% (n=4) considered their pain education to be sufficient. Conclusions Our results indicate that more contact hours are devoted to pain education on the Finnish UASs' physiotherapy programs at bachelor's level, than has previously been reported in faculty surveys. A separate pain course is one way to ensure a sufficient amount of pain education. Overall, despite a sufficient time devoted to pain education, some essential pain contents were inadequately covered. Implications The study contributes information on how pain education can be organized on physiotherapy programs at undergraduate level. Besides a sufficient amount of pain education, which can be ensured by a separate pain course, attention should be paid to pain education content being up-to-date. This could help in estimating the different proportions of pain content needed in educational settings. Efforts should also be made at keeping integrated pain education well-coordinated and purposeful. There is a need for further research estimating the effectiveness of pain education according to the different ways in which it is organized. There is also a need to investigate whether more hours allocated to pain education results in better understanding and professional skills.

摘要

背景与目的 尽管疼痛已被公认为一个全球性的健康问题,且在有效疼痛管理方面已取得进展,但针对本科医护专业人员的疼痛教育仍显不足。本研究调查了芬兰应用科学大学(UASs)本科理疗专业课程中疼痛教育的内容以及分配给疼痛教育的时间。方法 向芬兰所有开设本科理疗专业的UASs(n = 15)的理疗专业主任发送了一份基于网络的调查问卷。该问卷包含14个问题,涵盖疼痛的基本概念与科学、疼痛评估、疼痛管理以及疼痛课程的充足性。每个UASs填写一份问卷,即返回一份官方意见。结果 回复率为80%(n = 12)。疼痛教育的总接触时长平均为74小时(标准差34.2)。所有UASs都已将疼痛教育纳入课程。除此之外,42%(n = 5)的UASs设有单独的疼痛课程。在综合疼痛教育之外还开设此类课程的UASs,其疼痛内容教育时长是仅设有综合疼痛教育的UASs的两倍(平均103小时对53小时,p = 0.0043)。大部分教育内容集中在疼痛常见的病症、手法治疗以及用于控制疼痛的电疗法。疼痛的生物心理社会模型、疼痛管理的认知行为方法、医生管理以及多学科管理是涵盖最少的主题。五个UASs(42%)关注了国际疼痛研究协会的课程大纲,只有33%(n = 4)认为其疼痛教育足够。结论 我们的结果表明,芬兰UASs本科理疗专业课程中分配给疼痛教育的接触时长比之前教师调查中报告的要多。开设单独的疼痛课程是确保足够疼痛教育量的一种方式。总体而言尽管在疼痛教育上投入了足够的时间,但一些重要的疼痛内容仍未得到充分涵盖。启示 本研究提供了关于本科理疗专业课程中如何组织疼痛教育的信息。除了通过单独的疼痛课程确保足够的疼痛教育量外,还应关注疼痛教育内容的时效性。这有助于估计教育环境中所需的不同疼痛内容比例。还应努力保持综合疼痛教育的良好协调和针对性。有必要进一步研究根据疼痛教育的不同组织方式评估其有效性。还需要调查分配更多时间给疼痛教育是否会带来更好的理解和专业技能。

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