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荷兰手动理疗师对非特异性下腰痛患者进行的心理评估。

Psychological assessments by manual physiotherapists in the Netherlands in patients with nonspecific low back pain.

机构信息

Department of Master Education, SOMT University of Physiotherapy, Amersfoort, The Netherlands.

Physiotherapy and Manual Therapy, SaFyR Physiotherapy, Krabbendijke, The Netherlands.

出版信息

J Man Manip Ther. 2021 Oct;29(5):310-317. doi: 10.1080/10669817.2021.1919283. Epub 2021 Apr 28.

Abstract

: Clinical Practice Guidelines for low back pain emphasize implementing assessment and addressing of psychosocial context. It is unknown to what extent manual physiotherapists incorporate psychological factors in their diagnostic management of patients with nonspecific low back pain.: An online survey among Dutch manual physiotherapists was conducted exploring the use of 10 psychological constructs. Frequencies of attention to psychological factors during history-taking and use of questionnaires were calculated. Associations between therapists characteristics and use of psychological questionnaires were analyzed using Spearmans rank correlation coefficient (r s) and logistic regression. In addition, a retrospective patient record review was conducted.: One hundred and twelve manual physiotherapists returned completed surveys. Although respondents indicated psychological factors were assessed, they rarely used psychological questionnaires. Significant but negligible associations were found for age and working hours and the use of specific questionnaires. From 95 patient records reviewed, seven were identified that mentioned one psychological factor each during history taking.: Dutch MPTs, regardless of their age and work characteristics, rarely use psychological questionnaires in patients with LBP, although they report addressing these constructs implicitly during history taking. Educational and implementation strategies are needed to warrant the use of psychological constructs and validated psychological questionnaires at all phases of the clinical reasoning process.

摘要

临床实践指南强调对下腰痛进行评估和处理心理社会背景。目前尚不清楚手法治疗师在对非特异性下腰痛患者进行诊断管理时在多大程度上纳入心理因素。对荷兰手法治疗师进行了在线调查,以探讨使用 10 种心理结构。计算了在问诊过程中关注心理因素的频率和使用问卷的频率。使用Spearman 秩相关系数(rs)和逻辑回归分析治疗师特征与心理问卷使用之间的相关性。此外,还进行了回顾性患者病历审查。112 名手法治疗师返回了完整的调查。尽管受访者表示评估了心理因素,但他们很少使用心理问卷。年龄和工作时间与特定问卷的使用之间存在显著但微不足道的关联。从 95 份回顾的病历中,发现有 7 份在问诊过程中提到了一个心理因素。荷兰 MPTs 无论年龄和工作特点如何,在治疗下腰痛患者时很少使用心理问卷,尽管他们在问诊过程中会隐式地处理这些结构。需要教育和实施策略,以保证在临床推理过程的所有阶段使用心理结构和经过验证的心理问卷。

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