School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.
Musculoskelet Sci Pract. 2019 Dec;44:102067. doi: 10.1016/j.msksp.2019.102067. Epub 2019 Sep 29.
Musculoskeletal ultrasound imaging, (MSKUSI) has become a popular imaging modality in recent years and is being utilised by a variety of professions in clinical environments beyond radiology departments. A previously published study exploring physiotherapists' interests and use of MSKUSI in practice included in-depth interviews of participants, (n = 11). The data from this qualitative study were analysed thematically and five themes were identified; one was 'Application of the biopsychosocial model', the basis of this paper.
The theme, 'Application of the biopsychosocial model' drew together three categories of analysed data: clinical reasoning, professional variance and communication opportunity. 'Clinical reasoning' reflected the participants' value on subjective assessment information and the integration of ultrasound imaging with physical examination findings. 'Professional variance' observed the scanning processes undertaken by physiotherapists tended to vary from other professionals, the physiotherapists perceived their use of dynamic imaging was greater, in particular scanning in symptom provoking positions. Another variance observed was the style of communication that physiotherapists used when scanning, this was categorised as a 'communication opportunity' as it represented an event that could be utilised to promote patient understanding of their presentation, link imaging findings to proposed management and enhance compliance with rehabilitation strategies. Participants emphasised their responsibility when communicating with patients to avoid language that could promote unhelpful behaviour, e.g. catastrophisation.
Participants placed value on integrating musculoskeletal ultrasound imaging into the biopsychosocial model, further research to explore the impact of this approach on patients' clinical outcomes and reported experiences is required.
肌肉骨骼超声成像(MSKUSI)近年来已成为一种流行的成像方式,除放射科外,许多临床专业人员也在临床环境中使用。此前一项探讨物理治疗师在实践中对 MSKUSI 的兴趣和使用的研究包括对 11 名参与者的深入访谈。这项定性研究的数据进行了主题分析,确定了五个主题,其中一个是“生物心理社会模式的应用”,本文即基于该主题。
主题“生物心理社会模式的应用”将三个类别的分析数据结合在一起:临床推理、专业差异和沟通机会。“临床推理”反映了参与者对主观评估信息的重视以及将超声成像与体检结果相结合。“专业差异”观察到物理治疗师进行的扫描过程与其他专业人员不同,物理治疗师认为他们更频繁地使用动态成像,特别是在引起症状的位置进行扫描。另一个观察到的差异是物理治疗师在扫描时使用的沟通风格,这被归类为“沟通机会”,因为它代表了一个可以用来促进患者对其表现的理解、将成像结果与拟议的管理联系起来并提高康复策略依从性的事件。参与者强调在与患者沟通时的责任,避免使用可能促进无益行为的语言,例如灾难化。
参与者重视将肌肉骨骼超声成像整合到生物心理社会模式中,需要进一步研究来探讨这种方法对患者临床结果和报告体验的影响。