整骨疗法中疼痛咨询的使用：对澳大利亚整骨医生全国代表性样本的二次分析。

Utilisation of pain counselling in osteopathic practice: secondary analysis of a nationally representative sample of Australian osteopaths.

机构信息

School of Health and Biomedical Sciences, RMIT University, Bundoora Campus, 264 Plenty Rd, Mill Park 3082, Melbourne, VIC, Australia.

Department of Medical Education, University of Melbourne, Melbourne, VIC, Australia.

出版信息

Scand J Pain. 2020 Oct 28;21(2):330-338. doi: 10.1515/sjpain-2020-0058. Print 2021 Apr 27.

DOI:10.1515/sjpain-2020-0058

PMID:34387951

Abstract

OBJECTIVES

Advice, reassurance and education are recommended as first line treatments for musculoskeletal pain conditions such as low back pain. Osteopaths are registered primary contact allied health professionals in the Australian healthcare system who primarily manage acute and chronic musculoskeletal pain conditions. This study aimed to investigate the proportion of Australian osteopaths who do and do not utilise advice, reassurance and education (pain counselling) in their clinical practice, and determine the characteristics associated with the frequency of using pain counselling in clinical practice.

METHODS

A secondary analysis of practice characteristics from a nationally representative sample of Australian osteopaths was undertaken. Participants completed a 27-item practice characteristics questionnaire between July-December 2016. Bivariate analyses were used to identify significant variables for inclusion in a backward multiple logistic regression model. Adjusted odds ratios (OR) were calculated for significant variables.

RESULTS

Responses were received from 991 Australian osteopaths, representing 49% of the profession. Of these 264 (26.64%) indicated utilising pain counselling, and 727 (73.36%) reported utilising pain counselling. Those who utilised pain counselling were more than twice as likely to report research evidence had a high impact on their clinical practice (OR 2.11), and nearly twice as likely to discuss physical activity with their patients (OR 1.84).

CONCLUSIONS

Pain counselling is under-utilised by nearly three quarters of the Australian osteopathic profession as a management strategy. Future studies are required to explore the reasons why most in the profession comprised in this sample are infrequently utilising this guideline recommendation. Given the frequency of chronic musculoskeletal pain conditions presenting to Australian osteopaths, strategies appear to be needed to advance the profession via professional development in accessing and using evidence-based care for pain conditions.

摘要

目的

对于肌肉骨骼疼痛病症（如腰痛），建议、安慰和教育作为一线治疗方法。整骨医生是澳大利亚医疗体系中注册的初级接触的联合健康专业人员，主要管理急性和慢性肌肉骨骼疼痛病症。本研究旨在调查澳大利亚整骨医生在临床实践中运用建议、安慰和教育（疼痛咨询）的比例，并确定与疼痛咨询在临床实践中使用频率相关的特征。

方法

对澳大利亚整骨医生的一项具有全国代表性的样本的实践特征进行二次分析。参与者于 2016 年 7 月至 12 月期间完成了一份包含 27 个问题的实践特征问卷。采用单变量分析来确定纳入向后多项逻辑回归模型的显著变量。对显著变量进行调整后的优势比（OR）计算。

结果

收到了 991 名澳大利亚整骨医生的回复，占该职业的 49%。其中 264 名（26.64%）表示运用了疼痛咨询，727 名（73.36%）报告运用了疼痛咨询。运用疼痛咨询的人报告其临床实践受研究证据影响很大的可能性是其两倍多（OR 2.11），与患者讨论体育活动的可能性几乎是其两倍（OR 1.84）。