Department of Physiotherapy, Faculty of Health Sciences, Ariel University, Ariel, Israel.
Department of Physiotherapy, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2022 Jun;24(6):369-374.
Low back pain has been the leading cause for disability worldwide for several decades, and clinical guidelines for its management clearly emphasize a multifactorial approach. Yet, current guidelines are still not well implemented by clinicians.
To explore the attitudes of family medicine residents regarding low back pain and to determine whether they positively correlate with their treatment approaches. To test if these attitudes can be affected by the Enhanced Transtheoretical Model Intervention (ETMI), a guideline-based workshop.
Participants completed an online questionnaire regarding their attitudes toward low back pain and clinical habits, after which they attended an online ETMI educational workshop. One month later all participants were asked to complete the questionnaire a second time. Statistical analysis was conducted to explore the attitudes of the residents and clinical approaches, as well as any associations between them, as well as possible differences pre- and post-intervention.
The participants exhibited highly psychologically oriented attitudes. Correlations between the attitudes and treatment did not show consistent coherency. Results regarding the participants clinical approaches were revealed to have two distinct and opposed inclinations: biomedically and biopsychosocially. Last, results for the re-activation subscale were significantly higher post-intervention.
Family medicine residents seem to be highly psychologically oriented regarding low back pain; however, they do not necessarily treat their patients accordingly. Their clinical choices seem to follow two different approaches: guideline-consistent and non-guideline-consistent. An ETMI guideline-based workshop may sway their attitudes toward re-activation of patients. Further research is needed to determine whether similar results would arise in larger physician populations.
几十年来，下背痛一直是全球导致残疾的主要原因，其管理的临床指南明确强调了多因素方法。然而，临床医生仍然没有很好地实施当前的指南。
探讨家庭医学住院医师对下背痛的态度，并确定其是否与他们的治疗方法呈正相关。测试这些态度是否可以通过基于循证指南的增强跨理论模型干预（ETMI）来改变。
参与者在完成有关他们对下背痛和临床习惯的态度的在线问卷调查后，参加了一个在线 ETMI 教育研讨会。一个月后，所有参与者都被要求再次完成问卷。进行了统计分析，以探讨居民的态度和临床方法，以及它们之间的任何关联，以及干预前后的可能差异。
参与者表现出高度心理导向的态度。态度和治疗之间的相关性没有显示出一致的一致性。参与者临床方法的结果显示出两种截然不同且对立的倾向：生物医学和生物心理社会。最后，干预后再激活子量表的结果明显更高。
家庭医学住院医师似乎对下背痛有很高的心理倾向；然而，他们不一定会相应地治疗他们的患者。他们的临床选择似乎遵循两种不同的方法：符合指南和不符合指南。基于循证指南的 ETMI 研讨会可能会改变他们对患者再激活的态度。需要进一步研究以确定在更大的医生人群中是否会出现类似的结果。
