Faculty of Health, Witten/Herdecke University, Witten, Germany.
Department of Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany.
BMC Med Imaging. 2021 Jan 13;21(1):11. doi: 10.1186/s12880-020-00544-6.
Back pain is a common problem and a burden for the patient. MR-morphologically proven pain-causing changes of the spine is often successfully treated utilizing CT-guided pain therapy. The CT-guided execution enables a controlled and reproducible therapy. Nevertheless, treatment results can differ even with the same patient; the physician is a possible influencing factor of the outcome. Accordingly, the present study analyzes the different behaviors and forms of communication of the treating physicians during the course of the intervention as factors influencing the outcome of treatment.
67 patients suffering from specific back pain were included in this study. 5 treating physicians (2 female, 3 male) of different age (29-63 years), and experience and a total of 244 CT-guided treatments were included in this study. In every case a psychologist observed the treatment based on a standardized observation protocol. Observed were both the verbal and non-verbal interactions as well as the reaction of patient and physician. The success of the therapy was measured in the course of the treatment using the visual analogue pain scale. The technical comparability of the performed CT-guided periradicular therapy was ensured by the distribution of the drug mixture.
The outcome is significantly better if the patient considers the treating physician to be competent (correlation coefficient: 0.24, p < 0.006) and feels understood (correlation coefficient: 0.29, p < 0.001). In addition, the outcome is better when the physician believes that the treatment brings a positive reduction of pain, underlining his belief with positive statements of affirmation before the intervention thus creating a positive atmosphere [correlation coefficient: 0.24 (p < 0.009)]. In contrast, the outcome is worse if the patient complains about pain during the intervention [average pain reduction M = 0.9 (pain group) vs. M = 2.0 (no-pain group)].
Our study shows that with comparable implementation of CT-guided periradicular therapy, the outcome of the patient with specific back pain can be significantly improved by certain behavioral patterns of the performing physician and this without side effects and without significant additional time expenditure. Our findings indicate that there is a non-negligible psychological factor linking confidence in therapy to actual therapy success.
The study was designed as an observational study, therefore a trial registration was not necessary.
腰痛是一种常见的问题，给患者带来负担。磁共振形态学证实的脊柱疼痛引起的变化通常可以利用 CT 引导下的疼痛治疗成功治疗。CT 引导下的执行可实现可控且可重复的治疗。然而，即使对同一患者进行治疗，治疗结果也可能有所不同；医生是治疗结果的一个可能影响因素。因此，本研究分析了治疗医生在干预过程中的不同行为和沟通方式，这些因素可能会影响治疗结果。
本研究纳入了 67 名患有特定腰痛的患者。5 名不同年龄（29-63 岁）、经验不同的治疗医生（2 名女性，3 名男性）和总共 244 例 CT 引导下的治疗纳入了本研究。在每种情况下，心理学家都根据标准化观察方案观察治疗。观察了言语和非言语互动以及患者和医生的反应。治疗过程中使用视觉模拟疼痛量表来衡量治疗的成功。通过药物混合的分布确保了所进行的 CT 引导的神经根周围治疗的技术可比性。
如果患者认为治疗医生有能力（相关系数：0.24，p < 0.006）并且感到被理解（相关系数：0.29，p < 0.001），则治疗结果明显更好。此外，如果医生认为治疗会带来积极的疼痛减轻，并在干预前通过积极的肯定陈述来强调他的信念，从而营造积极的氛围，那么治疗结果会更好[相关系数：0.24（p < 0.009）]。相比之下，如果患者在干预过程中抱怨疼痛，治疗结果会更差[平均疼痛减轻 M = 0.9（疼痛组）与 M = 2.0（无疼痛组）]。
我们的研究表明，在实施可比的 CT 引导下的神经根周围治疗的情况下，特定腰痛患者的治疗结果可以通过执行医生的某些行为模式得到显著改善，而且没有副作用，也没有显著增加时间消耗。我们的发现表明，存在一个不可忽视的心理因素，将对治疗的信心与实际治疗效果联系起来。
本文是对原文的翻译，译文仅供参考，具体内容请以原文为准。
