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从有关膝关节骨关节炎的信息手册中去除病理解剖学内容不会影响对影像学检查或手术的看法,但会降低人们认为运动有损害的认知,并提高骨关节炎知识水平:一项在线随机对照试验。

Removing Pathoanatomical Content From Information Pamphlets About Knee Osteoarthritis Did Not Affect Beliefs About Imaging or Surgery, but Led to Lower Perceptions That Exercise Is Damaging and Better Osteoarthritis Knowledge: An Online Randomised Controlled Trial.

作者信息

Lawford Belinda J, Bennell Kim L, Hall Michelle, Egerton Thorlene, Filbay Stephanie, McManus Fiona, Lamb Karen E, Hinman Rana S

出版信息

J Orthop Sports Phys Ther. 2023 Apr;53(4):202-216. doi: 10.2519/jospt.2022.11618. Epub 2022 Dec 12.

Abstract

Compare the effects of osteoarthritis information, with or without pathoanatomical content, on people's beliefs about managing osteoarthritis. Online randomized controlled trial involving 556 participants. Participants considered a hypothetical scenario where their doctor informed them that they had knee osteoarthritis. Participants were randomized to a control condition, where they received currently available osteoarthritis information with pathoanatomical content or an experimental condition, where they received the same osteoarthritis information but without pathoanatomical content. Primary outcomes were participants' beliefs about the need for x-ray to confirm diagnosis and joint replacement surgery in the future. There were no between-group differences in primary outcomes for x-ray (mean difference [MD], -0.3; 95% confidence interval [CI]: -0.9, 0.4) and surgery (MD, -0.2; 95% CI: -0.7, 0.2), each rated on an 11-point numeric rating scale. Participants in the experimental group had lower perceptions that exercise would damage the knee (MD, -0.4; 95% CI: -0.8, 0.0; rated on an 11-point numeric rating scale) and better osteoarthritis knowledge (MD, 0.9; 95% CI: 0.0, 1.9; rated on a scale ranging from 11 to 55). Among those without tertiary education, participants in the experimental group had lower perceptions that x-ray was necessary than control (MD, -0.8; 95% CI: -1.5, -0.1). Among those who had never sought care for knee pain, participants in the experimental group had lower perceptions about the need for surgery (MD, -0.7; 95% CI: -1.2, -0.2). Removing pathoanatomical content may not change beliefs about imaging and surgery but may lead to lower perceptions that exercise is damaging and may improve osteoarthritis knowledge. However, effects were small and of unclear clinical relevance. Tertiary education or a history of care seeking for knee pain may moderate effects on primary outcomes. .

摘要

比较有无病理解剖内容的骨关节炎信息对人们关于骨关节炎管理信念的影响。一项涉及556名参与者的在线随机对照试验。参与者考虑了一种假设情景,即他们的医生告知他们患有膝关节骨关节炎。参与者被随机分配到对照组,在该组中他们收到包含病理解剖内容的现有骨关节炎信息,或被分配到试验组,在该组中他们收到相同的骨关节炎信息,但不包含病理解剖内容。主要结局是参与者对于未来通过X光确认诊断以及进行关节置换手术必要性的信念。在X光(平均差[MD],-0.3;95%置信区间[CI]:-0.9,0.4)和手术(MD,-0.2;95%CI:-0.7,0.2)的主要结局方面,两组之间没有差异,每项结局均采用11分数字评分量表进行评分。试验组的参与者认为运动损伤膝关节的程度较低(MD,-0.4;95%CI:-0.8,0.0;采用11分数字评分量表进行评分),并且骨关节炎知识掌握得更好(MD,0.9;95%CI:0.0,1.9;采用11至55分的量表进行评分)。在未接受高等教育的人群中,试验组的参与者认为X光必要性低于对照组(MD,-0.8;95%CI:-1.5,-0.1)。在从未因膝关节疼痛寻求过治疗的人群中,试验组的参与者对手术必要性的认知较低(MD,-0.7;95%CI:-1.2,-0.2)。去除病理解剖内容可能不会改变关于影像学检查和手术的信念,但可能会降低对运动有损伤的认知,并可能改善骨关节炎知识。然而,这些影响较小且临床相关性不明确。高等教育或有膝关节疼痛就医史可能会缓和对主要结局的影响。

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