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以人为本的腰痛患者教育与咨询:充分利用已知知识。

Person-centred education and advice for people with low back pain: Making the best of what we know.

机构信息

Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Braz J Phys Ther. 2023 Jan-Feb;27(1):100478. doi: 10.1016/j.bjpt.2022.100478. Epub 2022 Dec 22.

Abstract

BACKGROUND

The first-line treatment consistently recommended for people with low back pain is patient education and advice. Regardless of the duration of low back pain, clinicians should provide education on the benign nature of low back pain, reassurance about the absence of a serious medical condition, and advice to remain active. There is little guidance on how best to provide this care.

OBJECTIVE

This Masterclass will draw on recent evidence to explore how physical therapy clinicians could deliver person-centred education and advice to people with low back pain to refine their clinical consultation.

DISCUSSION

First, we highlight the potential value of providing validation to acknowledge the distressing experience and consequences of low back pain. Second, we describe a tool to open channels of communication to provide education and advice in a patient-centred and efficient way. Clinicians could consider using the Attitude toward Education and advice for Low back pain Questionnaire to gain an insight into patient attitudes toward education and advice at the outset of a clinical encounter. Finally, we provide options for tailoring patient education and advice to promote self-management of low back pain based on patient attitudes. We present evidence that a positive attitude toward messages about causes rather than messages about physical activity predicts intention to self-manage low back pain. We combine this evidence to suggest a pathway for clinicians to provide education and advice to people with low back pain within the time constraints of a clinical consultation.

摘要

背景

对于腰痛患者,一线治疗方法始终是患者教育和建议。无论腰痛持续时间如何,临床医生都应提供关于腰痛良性性质的教育,对没有严重疾病的保证,并建议保持活动。关于如何最好地提供这种护理的指导很少。

目的

本大师班将借鉴最新证据,探讨物理治疗临床医生如何为腰痛患者提供以人为本的教育和建议,以完善他们的临床咨询。

讨论

首先,我们强调提供验证的潜在价值,以承认腰痛的痛苦经历和后果。其次,我们描述了一种工具,以打开沟通渠道,以患者为中心和高效的方式提供教育和建议。临床医生可以考虑使用腰痛教育和建议态度问卷,以在临床就诊开始时深入了解患者对教育和建议的态度。最后,我们提供了根据患者态度调整患者教育和建议以促进腰痛自我管理的选择。我们提供的证据表明,对病因信息的积极态度而非对体育活动信息的积极态度预测了自我管理腰痛的意愿。我们结合这些证据,为临床医生在临床咨询的时间限制内为腰痛患者提供教育和建议提供了一条途径。

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