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物理治疗师对急性下背痛中心理社会因素的考量。

Consideration of Psychosocial Factors in Acute Low Back Pain by Physical Therapists.

作者信息

Otero-Ketterer Emilia, Peñacoba-Puente Cecilia, Ortega-Santiago Ricardo, Galán-Del-Río Fernando, Valera-Calero Juan Antonio

机构信息

Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.

Physiotherapy Department, Mutua Universal Mugenat, 28801 Alcalá de Henares, Spain.

出版信息

J Clin Med. 2023 Jun 5;12(11):3865. doi: 10.3390/jcm12113865.

Abstract

Clinical guidelines consistently recommend screening psychosocial (PS) factors in patients with low back pain (LBP), regardless of its mechanical nature, as recognized contributors to pain chronicity. However, the ability of physiotherapists (PTs) in identifying these factors remains controversial. This study aimed to assess the current identification of psychosocial risk factors by physical therapists (PTs) and which characteristics of PTs are associated with the identification of the main risk for chronicity (physical or psychosocial). A cross-sectional descriptive study surveying Spanish PTs in public and private health services was conducted, including questions on PT characteristics and three low back pain (LBP) patient vignettes with different biopsychosocial (BPS) clinical presentations. From 484 respondents, the majority of PTs agreed regarding the main risk for chronicity for each vignette (PS 95.7% for vignette A, PS and physical 83.5% for vignette B and PS 66% for vignette C). Female PTs were more likely to rate psychosocial compared with males ( < 0.05). PTs with higher levels of social and emotional intelligence (both, < 0.05) were more likely to identify the main risk for chronicity. However, only gender and social information processing for vignette A ( = 0.024) and emotional clarity for vignette B ( = 0.006) were able to predict the identification of psychosocial and physical risk, respectively. The main risk for chronicity was correctly identified by a large majority of PTs through patient vignettes. Gender, social and emotional intelligence played a relevant role in the recognition of psychosocial risk and biopsychosocial factors.

摘要

临床指南一直建议,无论下背痛(LBP)的机械性病因如何,都要对患者的心理社会(PS)因素进行筛查,因为这些因素被认为是导致疼痛慢性化的因素。然而,物理治疗师(PTs)识别这些因素的能力仍存在争议。本研究旨在评估物理治疗师(PTs)目前对心理社会风险因素的识别情况,以及PTs的哪些特征与慢性化主要风险(身体或心理社会)的识别相关。我们进行了一项横断面描述性研究,对公共和私人卫生服务机构中的西班牙PTs进行了调查,包括PT特征问题以及三个具有不同生物心理社会(BPS)临床表现的下背痛(LBP)患者案例。在484名受访者中,大多数PTs对每个案例的慢性化主要风险达成了共识(案例A中PS占95.7%,案例B中PS和身体因素占83.5%,案例C中PS占66%)。与男性相比,女性PTs更倾向于将其评定为心理社会因素(P<0.05)。社会和情商水平较高的PTs(两者P<0.05)更有可能识别出慢性化的主要风险。然而,只有案例A的性别和社会信息处理(P = 0.024)以及案例B的情绪清晰度(P = 0.006)能够分别预测心理社会和身体风险的识别。大多数PTs通过患者案例正确识别了慢性化的主要风险。性别、社会和情商在心理社会风险和生物心理社会因素的识别中发挥了相关作用。

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