Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands.
Musculoskelet Sci Pract. 2024 Oct;73:103121. doi: 10.1016/j.msksp.2024.103121. Epub 2024 Jun 13.
Many physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended intervention (Back2Action) was developed to assist physiotherapists to manage people with persistent spinal pain and coexisting psychosocial risk factors associated with the development or maintenance of persistent pain.
This study aimed to gain insight into the experiences of physiotherapists with this blended psychosocial intervention.
and methods: This was an interpretative qualitative study with a reflexive thematic analysis of semi-structured interviews with physiotherapists (N = 15) who delivered Back2Action. The interview started with the grand-tour question: "What was your experience in using Back2Action?" Physiotherapist were encouraged to provide examples, and follow-up questions were posed to ensure a deeper understanding could be reached.
Four themes were constructed: Physiotherapists became increasingly aware of (1) their own implicit expectations, biases and skills, and underlying treatment paradigms, and (2) the implicit expectations from their patients towards them. This led to (3) creating a deeper and stronger therapeutic alliance with the patient, but also (4) an understanding that implementation of a true biopsychosocial intervention - even if offered in a blended form - requires more practice, confidence and resources.
Back2Action is considered a valuable treatment to deliver a biopsychosocial intervention in primary care. Considering the high level of knowledge, skills and competency of the participating physiotherapists, the perceived barriers may be more difficult to overcome for more junior physiotherapists.
许多物理治疗师觉得自己无法充分应对复杂疼痛人群的心理社会风险因素。因此，开发了一种生物心理社会混合干预（Back2Action），以帮助物理治疗师管理患有持续性脊柱疼痛和与持续性疼痛发展或维持相关的并存心理社会风险因素的患者。
本研究旨在深入了解物理治疗师对这种混合心理社会干预的体验。
这是一项解释性定性研究，对 15 名实施 Back2Action 的物理治疗师进行半结构化访谈的反思性主题分析。访谈从大巡回问题开始：“使用 Back2Action 的体验是什么？”鼓励物理治疗师提供示例，并提出后续问题，以确保能够更深入地理解。
构建了四个主题：物理治疗师越来越意识到（1）他们自己的隐含期望、偏见和技能以及潜在的治疗模式，以及（2）患者对他们的隐含期望。这导致了（3）与患者建立更深更强的治疗联盟，但也（4）理解即使以混合形式提供真正的生物心理社会干预也需要更多的实践、信心和资源。
Back2Action 被认为是在初级保健中提供生物心理社会干预的一种有价值的治疗方法。考虑到参与的物理治疗师具有较高的知识、技能和能力水平，对于更初级的物理治疗师来说，感知到的障碍可能更难克服。
