物理治疗师在腰痛教育中使用负面语言会影响焦虑和疾病认知：一项针对健康受访者的随机对照试验。

Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: A randomised controlled trial in healthy respondents.

作者信息

Fieke Linskens F G, van der Scheer E S, Stortenbeker I, Das E, Staal J B, van Lankveld W

机构信息

Physical Therapy Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, the Netherlands.

HAN University of Applied Sciences, Research group Musculoskeletal Rehabilitation Nijmegen, Nijmegen, the Netherlands.

出版信息

Patient Educ Couns. 2023 May;110:107649. doi: 10.1016/j.pec.2023.107649. Epub 2023 Jan 27.

DOI:10.1016/j.pec.2023.107649

PMID:36764063

Abstract

OBJECTIVE

This study aimed to determine the effect of physiotherapists' negative language use on nocebo effects of state anxiety and illness beliefs.

METHODS

A web-based randomised controlled trial included adults without recent musculoskeletal pain. The intervention was a short educational video about low back pain using negative language (nocebo condition: n = 87) versus a video using neutral or positive language (control condition: n = 82). State anxiety was assessed using the State-Trait Anxiety Inventory. Illness beliefs were assessed using the Illness Perception Questionnaire.

RESULTS

Nocebo and control groups differed in outcome measures (MANOVA Pillai's trace = 0.22, F = 4.98; df = (9,159), p < 0.001). Post-hoc analyses showed a medium to large effect for the nocebo condition on anxiety (d = 0.71, 95% CI 0.4 -1.0). The nocebo group also had higher scores in three illness beliefs: beliefs on timeline (d = 0.45, 95% CI 0.14 - 0.75), treatment control (d = 0.43, 95% CI 0.12 - 0.74) and concern (d = 0.47, 95% CI 0.16 - 0.78).

CONCLUSION

Physiotherapists' use of negative language contributes directly to a higher state anxiety and illness beliefs that can trigger the nocebo effects in the recipient PRACTICE IMPLICATIONS: Negative language use should be avoided.

摘要

目的

本研究旨在确定物理治疗师使用负面语言对状态焦虑和疾病信念的反安慰剂效应的影响。

方法

一项基于网络的随机对照试验纳入了近期无肌肉骨骼疼痛的成年人。干预措施是一段关于腰痛的简短教育视频，使用负面语言（反安慰剂组：n = 87）与使用中性或正面语言的视频（对照组：n = 82）。使用状态-特质焦虑量表评估状态焦虑。使用疾病认知问卷评估疾病信念。

结果

反安慰剂组和对照组在结局指标上存在差异（多变量方差分析 Pillai 迹 = 0.22，F = 4.98；自由度 = (9,159)，p < 0.001）。事后分析显示，反安慰剂组对焦虑有中等至较大的影响（d = 0.71，95% 置信区间 0.4 - 1.0）。反安慰剂组在三种疾病信念上的得分也更高：时间线信念（d = 0.45，95% 置信区间 0.14 - 0.75）、治疗控制信念（d = 0.43，95% 置信区间 0.12 - 0.74）和担忧信念（d = 0.47，95% 置信区间 0.16 - 0.78）。