School of Allied Health, Physiotherapy, HAN University of Applied Sciences, Nijmegen, the Netherlands.
School of Allied Health, Physiotherapy, HAN University of Applied Sciences, Nijmegen, the Netherlands.
Musculoskelet Sci Pract. 2021 Dec;56:102462. doi: 10.1016/j.msksp.2021.102462. Epub 2021 Sep 21.
A person-centred, biopsychosocial approach focused on self-management and a healthy lifestyle is recommended for managing non-specific low back pain (LBP).
What are the experiences of physiotherapists with regard to providing self-management support to people with non-specific LBP?
Exploratory qualitative.
Fourteen semi-structured interviews were conducted with physiotherapists in the Netherlands using a semi-structured and pilot tested interview guide. Data were analysed using inductive thematic analysis.
Physiotherapists believe that self-management has added value in the management of people with non-specific LBP. Motivational interviewing, providing advice and exercise were most frequently used to facilitate behaviour change aimed at enhancing patients' self-management. Support regarding self-management skills was not frequently mentioned. Physiotherapists are not fully aware of and do not fully integrate support with regard to important self-management skills. The most important barrier participants experienced with regard to integrating self-management was patient expectations. Another important barrier was addressing psychosocial factors. Most participants expressed a need to better integrate self-management support in their treatment. They explained that they needed more knowledge (courses, knowledge clips), opportunities to exchange experiences (peer review group) and tools for patients (app).
Physiotherapists do not fully integrate support with regard to important self-management skills in people with non-specific LBP. We recommend that physiotherapists address the identified barriers and needs and better include self-management support in their treatment of people with non-specific LBP. We recommend important stakeholders to collectively work on diminishing barriers to integrating self-management support.
以患者为中心，重视身心社会医学模式，强调自我管理和健康生活方式，这是目前非特异性下腰痛（LBP）管理的推荐方法。
物理治疗师在为非特异性 LBP 患者提供自我管理支持方面的经验是什么？
探索性定性研究。
荷兰的 14 名物理治疗师参与了这项半结构式访谈研究，采用半结构化和预先测试的访谈指南进行。使用归纳主题分析对数据进行分析。
物理治疗师认为自我管理在非特异性 LBP 患者的管理中具有附加价值。动机性访谈、提供建议和锻炼是最常用来促进行为改变以增强患者自我管理的方法。关于自我管理技能的支持则不常被提及。物理治疗师对支持重要自我管理技能的认识不足，也未能完全整合。参与者在整合自我管理方面遇到的最大障碍是患者的期望。另一个重要的障碍是解决心理社会因素。大多数参与者表示需要更好地将自我管理支持纳入他们的治疗中。他们解释说，他们需要更多的知识（课程、知识片段）、交流经验的机会（同行评审小组）和患者工具（应用程序）。
物理治疗师在非特异性 LBP 患者中没有完全整合支持重要自我管理技能的方法。我们建议物理治疗师解决已识别的障碍和需求，并在治疗非特异性 LBP 患者时更好地纳入自我管理支持。我们建议重要利益相关者共同努力，减少整合自我管理支持的障碍。
