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疼痛神经生理学教育对医学生疼痛知识、态度和行为的影响:一项混合方法随机对照试验。

The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial.

机构信息

School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, United Kingdom.

School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, United Kingdom.

出版信息

Musculoskelet Sci Pract. 2020 Dec;50:102249. doi: 10.1016/j.msksp.2020.102249. Epub 2020 Aug 28.

Abstract

OBJECTIVE

  1. To investigate the effects of a brief pain neuroscience education (PNE) lecture on multi-disciplinary healthcare students' knowledge, attitudes and behaviours towards people with pain post intervention and at 6-months follow-up, 2) To explore students' perceptions of PNE.

DESIGN

Mixed-methods randomized controlled trial.

SETTING

UK university.

PARTICIPANTS

Thirty-seven students (30♀, mean age 30 years) from six healthcare disciplines.

INTERVENTION

70-min PNE lecture (intervention group) or a 70-min control education.

MAIN OUTCOME MEASURES

  1. Knowledge: The Revised Pain Neurophysiology Quiz (RPNQ); 2) Attitudes: Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS); 3) Behaviours: A case vignette to assess clinical recommendations; and 4) Thematic analysis of semi-structured interviews (n = 12).

RESULTS

The intervention group increased knowledge compared to the control, post-intervention [mean difference 3.7 (95% CI, 2.4, 5.0), P < 0.001] but not at 6-months (0.1 (-1.1, 1.3), P = 0.860). Greater improvements in attitudes for the intervention group were seen post-intervention [-10.4 (-16.3, -4.6), P < 0.001] and at 6-months [-5.8 (-11.5, -0.2), P < 0.044]. There was no difference in behaviours between groups. Thematic analysis identified increased patient empathy, partial and patchy reconceptualisation of pain and increased confidence in recommending an active management programme following PNE.

CONCLUSION

This study adds to existing knowledge by demonstrating that a 70-min PNE lecture can have a short-term effect on knowledge and positively shift attitudes towards people with pain in the short and medium-term. It also resulted in some students' reconceptualisation of pain, increased empathy, and confidence to recommend activity. The effect of PNE on clinical behaviours was unclear.

摘要

目的

1)调查简短的疼痛神经科学教育(PNE)讲座对多学科医疗保健学生在干预后和 6 个月随访时对疼痛患者的知识、态度和行为的影响,2)探索学生对 PNE 的看法。

设计

混合方法随机对照试验。

地点

英国大学。

参与者

来自六个医疗保健学科的 37 名学生(30 名女性,平均年龄 30 岁)。

干预

70 分钟的 PNE 讲座(干预组)或 70 分钟的对照教育。

主要观察指标

1)知识:修订后的疼痛神经生理学测验(RPNQ);2)态度:医疗保健提供者的疼痛与功能障碍关系量表(HC-PAIRS);3)行为:评估临床建议的病例 vignette;4)半结构化访谈的主题分析(n=12)。

结果

与对照组相比,干预组在干预后知识增加[平均差异 3.7(95%置信区间,2.4,5.0),P<0.001],但在 6 个月时没有增加[0.1(-1.1,1.3),P=0.860]。干预组的态度在干预后得到了更大的改善[-10.4(-16.3,-4.6),P<0.001],6 个月时也有所改善[-5.8(-11.5,-0.2),P<0.044]。两组之间的行为没有差异。主题分析确定了增加对患者的同理心、对疼痛的部分和局部重新概念化以及对推荐积极管理计划的信心增加。

结论

本研究通过证明 70 分钟的 PNE 讲座可以在短期内对知识产生短期影响,并在短期和中期积极改变对疼痛患者的态度,从而增加了现有知识。它还导致一些学生对疼痛的重新概念化、增加同理心以及推荐活动的信心。PNE 对临床行为的影响尚不清楚。

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