Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway.
Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Phys Ther. 2019 Mar 1;99(3):339-353. doi: 10.1093/ptj/pzy139.
The Pain Attitudes and Beliefs Scale (PABS) for Physical Therapists aims to measure clinicians' biomedical and biopsychosocial treatment orientations regarding nonspecific low back pain.
The objective of this study was to assess whether the PABS can differentiate between subgroups of physical therapists hypothesized to differ in treatment orientations.
This study was a cross-sectional survey.
The PABS was completed by 662 Norwegian physical therapists with a diversity of professional backgrounds. Twenty-four a priori hypotheses on expected differences in PABS scores were formulated. Sufficient discriminative ability was defined as a minimum of 75% confirmed hypotheses. Hypotheses on differences in scores were tested for the biomedical and biopsychosocial subscales separately as well as for combinations of the 2 subscales, representing responders with high biomedical and low biopsychosocial PABS scores and vice versa.
Of the 24 hypotheses, only 15 (62.5%) were confirmed. Between-group differences concerning the separate subscales were small, varying from -0.63 to 1.70 scale points, representing values up to 6.0% of the total subscale ranges. Between-group differences were larger when combined subscales were used, varying from 1.80 to 6.70 points, representing values up to 25.1% of the total subscale ranges. Despite little spread in scores, 24% of respondents demonstrated extreme attitudes.
The lack of convincing scientific evidence from previous research on differences in attitudes and beliefs between physical therapists was a limitation for the formulation of hypotheses.
Discriminative validity of separate subscales of the PABS was not supported. Combining the 2 subscales into global treatment attitudes enabled better discrimination. Little spread in biomedical and biopsychosocial orientations explains why more than one-third of the hypotheses were not confirmed. Either Norwegian physical therapists are basically similar in their treatment orientation or the PABS is not able to detect any differences between them.
物理治疗师疼痛态度和信念量表（PABS）旨在衡量临床医生针对非特异性下腰痛的生物医学和生物心理社会治疗方向。
本研究旨在评估 PABS 是否可以区分假设在治疗方向上存在差异的物理治疗师亚组。
这是一项横断面调查研究。
662 名具有不同专业背景的挪威物理治疗师完成了 PABS。共提出了 24 项关于 PABS 分数预期差异的先验假设。将至少有 75%的假设得到证实定义为具有足够的区分能力。分别对生物医学和生物心理社会子量表以及这两个子量表的组合进行了分数差异的检验，代表高生物医学和低生物心理社会 PABS 分数的反应者和相反的情况。
在 24 个假设中，只有 15 个（62.5%）得到证实。关于单独子量表的组间差异较小，范围为-0.63 至 1.70 个量表点，代表总分量表范围的 6.0%。当使用组合子量表时，组间差异更大，范围为 1.80 至 6.70 个点，代表总分量表范围的 25.1%。尽管分数分布较窄，但仍有 24%的受访者表现出极端的态度。
先前关于物理治疗师态度和信念差异的研究缺乏令人信服的科学证据，这限制了假设的制定。
单独子量表的 PABS 区分效度未得到支持。将两个子量表组合成整体治疗态度可以更好地区分。生物医学和生物心理社会方向的分布较窄，解释了为什么超过三分之一的假设未得到证实。要么挪威物理治疗师在治疗方向上基本相似，要么 PABS 无法检测到他们之间的任何差异。
