Doctor of Physical Therapy Division, Duke University, Durham, NC, USA.
Doctor of Physical Therapy Division, Duke University, Durham, NC, USA.
Musculoskelet Sci Pract. 2020 Oct;49:102223. doi: 10.1016/j.msksp.2020.102223. Epub 2020 Jul 15.
It remains unclear as to what factors influence a patient's choice to seek care from a specific healthcare provider for low back and neck pain.
Utilize Andersen's Behavioral Model of Health Service Utilization as a conceptual framework to identify the predisposing, enabling and need factors associated with choice of healthcare provider for back and/or neck pain.
PubMed, CINAHL, EMBASE, and SCOPUS databases were searched for studies that included 1) patients seeking care for acute or chronic low back or neck pain; 2) patients at least 18 years of age; 3) reported any healthcare provider type chosen to be seen. Significant factors addressing a patient's choice of provider seen for back pain, neck pain, or both were extracted from studies and analyzed under the Behavioral Model of Health Service Utilization.
20 studies were included in this review: 17 quantitative studies and 3 qualitative studies. Provider types identified were medical physicians, chiropractors, physical therapists, acupuncturists and CAM providers. Age and sex were the most commonly reported predisposing factors; financial and personal factors were the most common enabling factors; patients' duration of pain and self-reported level of functioning were the most commonly reported need factors.
While predisposing and need factors are important, enabling factors also have an influence in choice of healthcare provider for back and/or neck pain.
对于影响患者选择特定医疗保健提供者治疗下腰痛和颈痛的因素，目前仍不清楚。
利用安德森健康服务利用行为模型作为概念框架，确定与选择下腰痛和/或颈痛医疗保健提供者相关的倾向因素、促成因素和需求因素。
在 PubMed、CINAHL、EMBASE 和 SCOPUS 数据库中搜索了以下研究：1）患者因急性或慢性下腰痛或颈痛寻求治疗；2）患者年龄至少 18 岁；3）报告选择的任何医疗保健提供者类型。从研究中提取出与患者选择治疗下腰痛、颈痛或两者的提供者相关的重要因素，并根据健康服务利用行为模型进行分析。
本综述纳入了 20 项研究：17 项定量研究和 3 项定性研究。确定的提供者类型包括内科医生、脊椎按摩师、物理治疗师、针灸师和补充和替代医学提供者。年龄和性别是最常报告的倾向因素；财务和个人因素是最常见的促成因素；患者的疼痛持续时间和自我报告的功能水平是最常报告的需求因素。
尽管倾向因素和需求因素很重要，但促成因素也会影响下腰痛和/或颈痛的医疗保健提供者选择。
