Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France.
Univ Angers, CHU Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Inserm, Angers, F- 49000, France.
BMC Prim Care. 2024 Jan 29;25(1):44. doi: 10.1186/s12875-024-02284-w.
Low back pain is the fourth most common reason for consulting a general practitioner (GP) among people aged 40-50 years. Beyond the overall benefits of physical activity (PA) on health (psychological, cardiovascular, etc.), PA for low back pain seems to improve the prognosis in terms of pain, disability, and quality of life. The French National Health Insurance developed media campaigns to promote physical activity with low back pain and a smartphone application (app). Despite the known benefits and campaigns, GPs do not routinely provide advice about physical activity during low back pain consultations. To promote giving physical activity advice for low back pain, there is a need to understand how GPs currently provide this advice and whether technology could help. This study aims to explore the content of physical activity advice for low back pain that GPs provide in France, and their opinion about healthcare smartphone app provided electronically via the internet (e-health apps) as a support for this advice.
This qualitative study was conducted with semi-structured individual interviews among French GPs. The verbatim was double coded using a coding tree. Thematic analysis was performed using an inductive approach.
Sixteen GPs from Maine et Loire, Sarthe, and Mayenne were included. The thematic analysis identified the following themes: GPs use a global patient-centred approach to physical activity advice for low back pain. The main goal is to enable patients to participate in their care. Advice was almost always general with little information about duration and frequency. The importance of patient-appropriate and easily achievable activities was emphasised. GPs referred patients to physiotherapists to reinforce regular physical activity, maintain motivation and improve patient adherence through supervision and follow-up. GPs knew little about e-health apps but felt they could be useful with young patients. The main barriers to their use included poor internet connection, lack of technical knowledge and no supervision meaning patients could injure themselves.
This is one of the first studies to assess the contents of physical activity advice GPs provide for low back pain. Further research is needed into the implementation of e-health apps for low back pain management.
Not applicable.
在 40-50 岁人群中，下背痛是全科医生（GP）就诊的第四大常见原因。除了身体活动（PA）对健康的整体益处（心理、心血管等）之外，PA 似乎可以改善下背痛的预后，包括疼痛、残疾和生活质量。法国国家健康保险制定了媒体活动，以促进患有下背痛的人进行身体活动，并开发了一款智能手机应用程序（app）。尽管已知有这些益处和活动，但全科医生在治疗下背痛时通常不会提供关于身体活动的建议。为了促进为下背痛提供身体活动建议，有必要了解全科医生目前提供这种建议的情况，以及技术是否可以提供帮助。本研究旨在探讨法国全科医生提供的下背痛身体活动建议的内容，以及他们对通过互联网提供的电子医疗保健智能手机应用程序（e-health apps）的看法，以此作为该建议的支持。
本定性研究对法国全科医生进行了半结构化的个人访谈。对逐字稿进行了双编码，使用编码树。使用归纳法进行了主题分析。
纳入了来自曼恩-卢瓦尔、萨尔特和马耶讷的 16 名全科医生。主题分析确定了以下主题：全科医生使用以患者为中心的整体方法为下背痛提供身体活动建议。主要目标是使患者能够参与到他们的治疗中。建议几乎总是笼统的，很少有关于持续时间和频率的信息。强调了患者适当且易于实现的活动的重要性。全科医生将患者转介给物理治疗师，以通过监督和随访加强定期身体活动、保持动力并提高患者的依从性。全科医生对电子健康应用程序了解甚少，但认为它们对年轻患者可能有用。使用的主要障碍包括互联网连接不良、缺乏技术知识以及缺乏监督，这意味着患者可能会受伤。
这是评估全科医生为下背痛提供的身体活动建议内容的首批研究之一之一。需要进一步研究电子健康应用程序在下背痛管理中的应用。
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