测量《挥鞭样损伤手册》法译本对急诊医师治疗方法和规避恐惧信念的影响。一项整群随机对照试验。

Measuring the impact of the French version of The Whiplash Book on both treatment approach and fear-avoidance beliefs among emergency physicians. A cluster randomized controlled trial.

机构信息

Department of Physical Medicine and Rehabilitation, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.

Clermont-Ferrand Auvergne University, Clermont-Ferrand, France.

出版信息

PLoS One. 2020 Mar 18;15(3):e0229849. doi: 10.1371/journal.pone.0229849. eCollection 2020.

DOI:10.1371/journal.pone.0229849

PMID:32187610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7080520/

Abstract

BACKGROUND

Whiplash-associated disorders have been the subject of much attention in the scientific literature and remain a major public health problem.

OBJECTIVE

Measure the impact of a validated information booklet on the fear-avoidance beliefs of emergency physicians and their approach to management regarding the treatment of whiplash-associated disorders.

METHODS

A prospective cluster randomized controlled study conducted with a sample of emergency medicine physicians. Fear-avoidance beliefs were measured using The Whiplash Belief Questionnaire (WBQ) and Fear-Avoidance Beliefs Questionnaire (FABQ). We assessed the approach to management based on the prescription of pharmacological and non-pharmacological treatments based on the advice given to patients. The validated information booklet was the French version of The Whiplash Book. A set of questionnaires was sent to participants pre- and post-intervention. The experimental intervention was the provision of The Whiplash Book. The control arm did not receive any training or information.

RESULTS

Mean fears and beliefs scores on inclusion were high: WBQ = 19.09 (± 4.06); physical activity FABQ = 11.45 (± 4.73); work FABQ = 13.85 (± 6.70). Improvement in fear-avoidance beliefs scores being greater in the intervention group was further confirmed by the variation in WBQ (-20 [-32; -6] vs. -6 [-16; 9]; p = 0.06), physical activity FABQ (-70 [-86; -50] vs. -15 [-40; 11]; p < 0.001), and work FABQ (-40 [-71; 0] vs. 0 [-31; 50]; p = 0.02). The emergency physicians' initial approach to management was not consistent with current guidelines. Reading the French version of The Whiplash Book could contribute to changing their approach to management in several areas on intra-group analysis.

CONCLUSION

The French version of The Whiplash Book positively influenced fear-avoidance beliefs among emergency physicians.

摘要

背景

挥鞭样损伤相关疾病一直是科学文献中的热门话题，仍是一个主要的公共健康问题。

目的

测量一本经过验证的信息手册对急诊医师的恐惧-回避信念以及他们在治疗挥鞭样损伤相关疾病时的管理方法的影响。

方法

这是一项前瞻性聚类随机对照研究，研究对象为一组急诊医师。使用 Whiplash Belief Questionnaire（WBQ）和 Fear-Avoidance Beliefs Questionnaire（FABQ）来衡量恐惧-回避信念。我们根据患者建议开出的药物和非药物治疗的处方来评估管理方法。经过验证的信息手册是《挥鞭伤手册》的法译本。在干预前后向参与者发送了一组问卷。实验组的干预措施是提供《挥鞭伤手册》。对照组未接受任何培训或信息。

结果

纳入时的平均恐惧和信念评分较高：WBQ = 19.09（±4.06）；身体活动 FABQ = 11.45（±4.73）；工作 FABQ = 13.85（±6.70）。实验组的恐惧-回避信念评分改善程度更大，这一点通过 WBQ 的变化（-20 [-32；-6] 对 -6 [-16；9]；p = 0.06）、身体活动 FABQ（-70 [-86；-50] 对 -15 [-40；11]；p < 0.001）和工作 FABQ（-40 [-71；0] 对 0 [-31；50]；p = 0.02）得到了进一步证实。急诊医师最初的管理方法不符合当前的指南。阅读《挥鞭伤手册》法译本可能有助于在组内分析中改变他们在几个领域的管理方法。