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患者报告的结局测量(PROMs):在物理治疗实践中的使用及其相关因素。

Patient-reported outcome measurements (PROMs): Use during the physical therapy practice and associated factors.

机构信息

Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Spain; Physiotherapy Department, Mutua Universal Mugenat, Madrid, Spain.

Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Spain.

出版信息

Musculoskelet Sci Pract. 2023 Apr;64:102744. doi: 10.1016/j.msksp.2023.102744. Epub 2023 Mar 10.

Abstract

OBJECTIVE

To assess the current level of routine use of psychosocial-related patient-reported outcome measurements (PROMs) in physical therapy practice and which physical therapist-level factors are associated with the use of these measurement instruments.

METHODS

We conducted an online survey study among Spanish physical therapists involved in the treatment of LBP patients in Public Health Service, Mutual Insurance Companies, and private practice during 2020. Descriptive analyses were conducted for reporting the number and instruments utilized. Thus, sociodemographic and professional features differences between PTs using and not using PROM were analyzed.

RESULTS

From 485 physiotherapists completing the questionnaire nationwide, 484 were included. A minority of therapists routinely used psychosocial-related PROMs (13.8%) in LBP patients and only 6.8% did so through standardized measurements instruments. The Tampa Scale for Kinesiophobia (28.8%) and the Pain Catastrophizing Scale (15.1%) were used most frequently. Physiotherapists working in Andalucía and País Vasco regions, in private practice environments, educated in psychosocial factors evaluation and management, considering psychosocial factors during the clinical practice and expecting patients' collaborative attitudes demonstrated significantly greater use of PROMS (p < 0.05).

CONCLUSIONS

This study showed that the majority of physiotherapists in Spain do not use PROMs for evaluating LBP (86.2%). From those physiotherapists using PROMs, approximately the half use validated instruments such as the Tampa Scale for Kinesiophobia or the Pain Catastrophizing Scale while the other half limit their evaluation to anamnesis and non-validated questionnaires. Therefore, developing effective strategies to implement and facilitate the use of psychosocial-related PROMs would enhance the evaluation during the clinical practice.

摘要

目的

评估心理社会相关患者报告结局测量(PROMs)在物理治疗实践中的常规使用水平,以及哪些物理治疗师层面的因素与这些测量工具的使用相关。

方法

我们于 2020 年在参与公共卫生服务、相互保险公司和私人执业的腰痛患者治疗的西班牙物理治疗师中开展了一项在线调查研究。报告了使用和未使用 PROM 的物理治疗师的数量和使用的工具,并进行了描述性分析。因此,分析了使用和未使用 PROM 的物理治疗师在人口统计学和专业特征方面的差异。

结果

全国共有 485 名物理治疗师完成了问卷,其中 484 名被纳入分析。只有少数治疗师在腰痛患者中常规使用心理社会相关的 PROM(13.8%),且仅有 6.8%通过标准化测量工具进行。Tampa 运动恐惧量表(28.8%)和疼痛灾难化量表(15.1%)使用最频繁。在安达卢西亚和巴斯克地区、私人执业环境中工作、接受过心理社会因素评估和管理教育、在临床实践中考虑心理社会因素并期望患者表现出合作态度的物理治疗师,显著更频繁地使用 PROM(p<0.05)。

结论

本研究表明,西班牙大多数物理治疗师未使用 PROM 评估腰痛(86.2%)。在使用 PROM 的物理治疗师中,约有一半使用了经过验证的工具,如 Tampa 运动恐惧量表或疼痛灾难化量表,而另一半则将评估局限于病史和未经验证的问卷。因此,制定有效的策略来实施和促进心理社会相关 PROM 的使用,将增强临床实践中的评估。

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