Devan Hemakumar, Godfrey Hazel K, Perry Meredith A, Hempel Dagmar, Saipe Barbara, Hale Leigh, Grainger Rebecca
Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand.
School of Psychology, Victoria University of Wellington, Wellington, New Zealand.
J Pain Res. 2019 Aug 12;12:2457-2472. doi: 10.2147/JPR.S206539. eCollection 2019.
Online health resources (websites, apps and social media) may be an adjunct to provide self-management support for people with persistent or chronic pain. Endorsement of online health resources by health care providers is crucial for uptake by end-users. The aim of this study was to investigate the current practices of New Zealand (NZ) health care providers in recommending online resources for persistent pain management, and to identify what factors predict health care providers' recommendations and to explore the common concerns.
An online survey of NZ health care providers (ie, chiropractors, general practitioners, nurses, occupational therapists, osteopaths, physiotherapists, psychologists, specialist consultants, and social workers) involved in the management of persistent pain was conducted. The recruitment strategy was tailored to each occupation via occupation-specific professional organizations, and by approaching multidisciplinary professional organizations.
Data from 213 health care providers were used in the final analysis. Most of the health care providers were physiotherapists (n=71), followed by chiropractors (n=39) and general practitioners (n=31). Fifty three percent (111/210) of health care providers reported currently recommending online resources. A multivariate logistic regression model showed that specialist interest in treating pain (OR=3.84; 95% CI: 1.66, 8.87; =0.002), and level of confidence in recommending online resources (OR=1.05; CI: 1.04, 1.07; <0.001), positively influenced recommending online resources. The majority of the health care providers (65%, 138/213) were concerned about the safety issues related to the risk of patients misinterpreting online information and to the lack of evidence-based information.
Half of the health care providers surveyed reported recommending online resources, which may suggest limited confidence in recommending, or knowledge of, existing online resources for persistent pain management. Ongoing education for health care providers on evidence-based online resources is required to recommend online resources as a self-management support tool for people with persistent pain.
在线健康资源（网站、应用程序和社交媒体）可能是为持续性或慢性疼痛患者提供自我管理支持的一种辅助手段。医疗保健提供者对在线健康资源的认可对于最终用户的接受程度至关重要。本研究的目的是调查新西兰医疗保健提供者在推荐用于持续性疼痛管理的在线资源方面的当前做法，确定哪些因素可预测医疗保健提供者的推荐，并探讨常见的担忧。
对参与持续性疼痛管理的新西兰医疗保健提供者（即脊椎按摩师、全科医生、护士、职业治疗师、整骨疗法师、物理治疗师、心理学家、专科顾问和社会工作者）进行了在线调查。招募策略通过特定职业的专业组织并联系多学科专业组织，针对每个职业量身定制。
最终分析使用了213名医疗保健提供者的数据。大多数医疗保健提供者是物理治疗师（n = 71），其次是脊椎按摩师（n = 39）和全科医生（n = 31）。53%（111/210）的医疗保健提供者报告目前推荐在线资源。多变量逻辑回归模型显示，对治疗疼痛的专科兴趣（OR = 3.84；95% CI：1.66，8.87；P = 0.002）以及推荐在线资源的信心水平（OR = 1.05；CI：1.04，1.07；P < 0.001）对推荐在线资源有积极影响。大多数医疗保健提供者（65%，138/213）担心与患者误解在线信息的风险以及缺乏循证信息相关的安全问题。
接受调查的医疗保健提供者中有一半报告推荐在线资源，这可能表明对推荐现有用于持续性疼痛管理的在线资源的信心有限或了解不足。需要对医疗保健提供者进行关于循证在线资源的持续教育，以便将在线资源推荐为持续性疼痛患者的自我管理支持工具。
