Institute of Health Sciences, Department of Physiotherapy, Universität zu Lübeck, Lübeck, Germany.
Institute of physiotherapy, Zürich University of applied Sciences (ZHAW), Katharina-Sulzer-Platz 9, Winterthur, CH-8401, Switzerland.
BMC Musculoskelet Disord. 2023 Jul 27;24(1):615. doi: 10.1186/s12891-023-06724-z.
The effectiveness of physiotherapy to reduce low back pain depends on patient adherence to treatment. Facilitators and barriers to patient adherence are multifactorial and include patient and therapist-related factors. This Delphi study aimed to identify an expert consensus on aspects facilitating the adherence of patients with back pain to physiotherapy.
International experts were invited to participate in a three-round standard Delphi survey. The survey contained 49 items (32 original and 17 suggested by experts) which were rated on 5-point Likert scales. The items were assigned to six domains. The consensus level was defined as 60%.
Of 38 invited experts, 15 followed the invitation and completed all three rounds. A positive consensus was reached on 62% of the 49 proposed items to facilitate adherence. The highest consensus was achieved in the domains "Influence of biopsychosocial factors" (89%) and "Influence of cooperation between physiotherapists and patients" (79%). Additional important domains were the "Influence of competencies of physiotherapists" (71%) and "Interdisciplinary congruence" (78%). "Administration aspects" and the "Use of digital tools" did not reach expert consensus.
Biopsychosocial factors, therapeutic skills, and patient-physiotherapist collaboration should be considered in physiotherapy practice to facilitate adherence in patients with LBP. Future studies should prospectively evaluate the effectiveness of individual or combined identified aspects for their influence on patient adherence in longitudinal study designs.
物理疗法减轻腰痛的效果取决于患者对治疗的依从性。患者和治疗师相关因素等多种因素都会影响患者对治疗的依从性。本德尔菲研究旨在确定专家对促进腰痛患者接受物理治疗依从性方面的共识。
邀请国际专家参与三轮标准德尔菲调查。该调查包含 49 个项目（32 个原始项目和 17 个专家建议项目），采用 5 点李克特量表进行评分。项目被分配到六个领域。共识水平定义为 60%。
在 38 名受邀专家中，有 15 名专家应邀并完成了所有三轮调查。对 49 个促进依从性的建议项目中的 62%达成了积极共识。在“生物心理社会因素的影响”（89%）和“物理治疗师与患者合作的影响”（79%）两个领域达成了最高共识。其他重要领域包括“物理治疗师能力的影响”（71%）和“跨学科一致性”（78%）。“管理方面”和“数字工具的使用”没有达成专家共识。
在物理治疗实践中，应考虑生物心理社会因素、治疗技能和患者-治疗师合作，以促进腰痛患者的依从性。未来的研究应前瞻性地评估个体或组合确定的方面对患者依从性的影响，在纵向研究设计中进行研究。
