Achten J P J, Mooren-van der Meer S, Pisters M F, Veenhof C, Koppenaal T, Kloek C J J
Master Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, the Netherlands; Center for Physical Therapy Research and Innovation in Primary Care, Julius HealthCare Centers, Utrecht, the Netherlands.
Master Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, the Netherlands.
Musculoskelet Sci Pract. 2022 Dec;62:102675. doi: 10.1016/j.msksp.2022.102675. Epub 2022 Oct 19.
Self-management support is considered an important component in the physiotherapeutic treatment of people with chronic low back pain. The stratified blended physiotherapy intervention e-Exercise Low Back Pain is an example of a self-management intervention. More insight may contribute to improving blended interventions to stimulate self-management after treatment and thus hopefully prevent chronicity and/or relapses in patients with chronic low back pain.
The aim of this study was to gain an in-depth understanding of the self-management behaviour after a physiotherapist guided blended self-management intervention in people with chronic low back pain.
A qualitative study with semi-structured interviews nested within a randomized controlled trial on the (cost-)effectiveness of e-Exercise Low Back Pain was conducted.
Thematic analysis was used to analyse the transcriptions. A hybrid process of both deductive and inductive approaches was used.
After 12 interviews, data saturation was reached. Analysis of the data yielded six themes related to self-management behaviour: illness beliefs, coping, cognitions, social support and resource utilization, physiotherapeutic involvement and motivation.
In our study the majority of the participants seemed to show adequate self-management behaviour when experiencing low back pain. Most participants first try to gain control over their low back pain themselves when experiencing a relapse before contacting the physiotherapist. Participants struggle in continuing health behaviour in pain free periods between relapses of low back pain. Physiotherapists are recommended to encourage long-term behaviour change. Additionally, better facilitation by the physiotherapist or additional functionalities in the app to stimulate social support might have a useful contribution.
自我管理支持被认为是慢性下腰痛患者物理治疗的重要组成部分。分层混合物理治疗干预措施“电子运动性下腰痛”就是一种自我管理干预的实例。深入了解可能有助于改进混合干预措施，以促进治疗后的自我管理，从而有望预防慢性下腰痛患者的病情慢性化和/或复发。
本研究的目的是深入了解在物理治疗师指导下，慢性下腰痛患者进行混合自我管理干预后的自我管理行为。
在一项关于“电子运动性下腰痛”（成本）效益的随机对照试验中，进行了一项包含半结构化访谈的定性研究。
采用主题分析法对访谈记录进行分析。使用了演绎法和归纳法相结合的混合过程。
进行了12次访谈后达到了数据饱和。数据分析得出了与自我管理行为相关的六个主题：疾病信念、应对方式、认知、社会支持与资源利用、物理治疗参与度和动机。
在我们的研究中，大多数参与者在经历下腰痛时似乎表现出了适当的自我管理行为。大多数参与者在复发时，在联系物理治疗师之前，首先会尝试自己控制下腰痛。参与者在腰痛复发的无疼痛期间，在持续健康行为方面存在困难。建议物理治疗师鼓励长期行为改变。此外，物理治疗师更好的引导或应用程序中促进社会支持的附加功能可能会有有益的作用。
