骨科手法治疗专业物理治疗师对与反安慰剂相关的效应和背景因素的了解：一项全国性调查的结果

What Physiotherapists Specialized in Orthopedic Manual Therapy Know About Nocebo-Related Effects and Contextual Factors: Findings From a National Survey.

作者信息

Rossettini Giacomo, Geri Tommaso, Palese Alvisa, Marzaro Chiara, Mirandola Mattia, Colloca Luana, Fiorio Mirta, Turolla Andrea, Manoni Mattia, Testa Marco

机构信息

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.

School of Physiotherapy, University of Verona, Verona, Italy.

出版信息

Front Psychol. 2020 Oct 20;11:582174. doi: 10.3389/fpsyg.2020.582174. eCollection 2020.

DOI:10.3389/fpsyg.2020.582174

PMID:33192904

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7606996/

Abstract

OBJECTIVE

The aim of this study was to investigate the knowledge of orthopedic manual therapists (OMTs) regarding context factors (CFs) capable of triggering nocebo effects during the treatment and how this knowledge is related to their socio-demographic features.

DESIGN

A cross-sectional online survey.

SETTING

National.

MAIN OUTCOME MEASURES

A 20 items questionnaire composed by open-ended and closed single-choice questions was administered to explore: (a) socio-demographic variables (10 questions); (b) the relation between different CFs and nocebo-related effects (2 questions); and (c) the knowledge of participants about nocebo-related effects and how they managed them in the clinical practice (8 questions).

PARTICIPANTS

1288 OMTs were recruited from the database of the Master in Rehabilitation of Musculoskeletal Disorders (MRDM) of the University of Genova from March to May 2019. Inclusion criteria were: (a) to possess a valid email account; (b) to understand and use as a native language the Italian; (c) to be graduated as OMTs; and (d) to be employed as physiotherapists specialized-OMTs during the survey.

RESULTS

791 responses were received (61.4%); 473 of them were male (59.8%), with an average age of 31.0 ± 7.1 years. OMTs defined nocebo-related effects as the psychosocial context effects around therapy and patient with specific biological bases (72.2%). OMTs know that their clinical practice is pervaded by nocebo-related effects (42.5%), triggered by CFs. Participants communicated nocebo-related effects balancing the positive features of the therapy with the negative ones (50.9%), during the decision of the therapeutic plan (42.7%). They reported associative learning as the main mechanism involved in nocebo-related effects (28.8%). OMTs taught and trained patient's strategies to manage nocebo-related effects (39.6%) through an evaluation and correction of patient's anxieties, doubts and expectations (37.7%). OMTs most frequently considered themselves to have a "medium" education about nocebo-related effects (48.2%) and that their management should be taught during bachelor (78.6%).

CONCLUSION

OMTs believed that nocebo-related effects were present in their clinical practice and that they can be triggered by CFs.

摘要

目的

本研究旨在调查骨科手法治疗师（OMT）对治疗过程中可能引发反安慰剂效应的背景因素（CF）的了解，以及这种了解与他们的社会人口学特征之间的关系。

设计

横断面在线调查。

地点

全国范围。

主要观察指标

采用一份由开放式和封闭式单项选择题组成的包含20个条目的问卷进行调查，以探究：（a）社会人口学变量（10个问题）；（b）不同CF与反安慰剂相关效应之间的关系（2个问题）；（c）参与者对反安慰剂相关效应的了解以及他们在临床实践中如何应对这些效应（8个问题）。

参与者

2019年3月至5月，从热那亚大学肌肉骨骼疾病康复硕士（MRDM）数据库中招募了1288名OMT。纳入标准为：（a）拥有有效的电子邮件账户；（b）理解并以意大利语为母语；（c）毕业于OMT专业；（d）在调查期间受雇为专业OMT物理治疗师。

结果

共收到791份回复（61.4%）；其中473名男性（59.8%），平均年龄为31.0±7.1岁。OMT将反安慰剂相关效应定义为围绕治疗和具有特定生物学基础的患者的心理社会背景效应（72.2%）。OMT知道他们的临床实践中普遍存在反安慰剂相关效应（42.5%），由CF引发。在制定治疗计划的过程中（42.7%），参与者通过平衡治疗的积极特征和消极特征来传达反安慰剂相关效应（50.9%）。他们报告联想学习是反安慰剂相关效应的主要机制（28.8%）。OMT通过评估和纠正患者的焦虑、疑虑和期望（37.7%）来教授和培训患者应对反安慰剂相关效应的策略（39.6%）。OMT最常认为自己对反安慰剂相关效应的了解为“中等”（48.2%），并且认为应该在本科阶段教授应对方法（78.6%）。