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“这非常复杂”:巴西刚毕业的物理治疗师对治疗非特异性下背痛的生物心理社会模型的看法和信念。

'It's very complicated': Perspectives and beliefs of newly graduated physiotherapists about the biopsychosocial model for treating people experiencing non-specific low back pain in Brazil.

机构信息

College of Physical Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil.

College of Occupational Therapy, University of Brasilia (UnB), Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, Distrito Federal, CEP: 72220-275, Brazil.

出版信息

Musculoskelet Sci Pract. 2019 Jul;42:84-89. doi: 10.1016/j.msksp.2019.04.011. Epub 2019 Apr 25.

Abstract

Non-specific low back pain is a common complaint frequently presented by patients and this complex clinical condition has challenged the biomedical model. The Biopsychosocial (BPS) model is recognized as an option for better guidance and patient management. However, physiotherapy training is based on the biomedical perspective, added to which, in clinical practice the applicability of the BPS model is a challenge for many professionals. In this article, we explore the feelings, beliefs, and attitudes of newly trained physiotherapists about using the BPS model to treat people with non-specific low back pain. It also aims to understand to what extent these physiotherapists are willing and prepared to use this model. Method: A qualitative phenomenological research was carried out in the Brazilian federal capital. A set of criteria was used to select 10 physiotherapists. The data were collected through semi-structured interviews and analyzed using five steps: familiarization, identification, indexation, mapping, and interpretation. Results: We identified one theme and three categories. The theme 'a practitioner physiotherapist can consider BPS aspects, but it is not necessary in his/her role to approach them' explains a shared belief about the use of BPS. The theme is better understood when looking at the three categories that explore and exemplify key elements of the theme: (i) understanding the BPS model and its relation to non-specific low back pain; (ii) the role of practitioner physiotherapists regarding the BPS model; and (iii) barriers: from undergraduate training to clinical settings.

摘要

非特异性下背痛是患者经常出现的一种常见症状,这种复杂的临床情况对生物医学模式提出了挑战。生物心理社会(BPS)模式被认为是更好地指导和管理患者的一种选择。然而,物理治疗培训是基于生物医学的观点,此外,在临床实践中,BPS 模式的适用性对许多专业人员来说是一个挑战。在本文中,我们探讨了新培训的物理治疗师对使用 BPS 模型治疗非特异性下背痛患者的感受、信念和态度。它还旨在了解这些物理治疗师在多大程度上愿意并准备使用这种模式。方法:在巴西联邦首都进行了定性现象学研究。使用一套标准选择了 10 名物理治疗师。通过半结构化访谈收集数据,并使用五个步骤进行分析:熟悉、识别、索引、映射和解释。结果:我们确定了一个主题和三个类别。主题“从业者物理治疗师可以考虑 BPS 方面,但在他/她的角色中没有必要接近它们”解释了对 BPS 使用的共同信念。当查看探索和例证主题关键要素的三个类别时,主题“从业者物理治疗师可以考虑 BPS 方面,但在他/她的角色中没有必要接近它们”可以得到更好的理解:(i)理解 BPS 模型及其与非特异性下背痛的关系;(ii)从业者物理治疗师在 BPS 模型中的角色;(iii)障碍:从本科培训到临床环境。

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