Mullen Nicholas, Ashby Samantha, Haskins Robin, Osmotherly Peter
School of Health Sciences, The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
John Hunter Hospital Outpatient Service, Hunter New England Health, Lookout Rd, New Lambton Heights, NSW, 2305, Australia.
Musculoskelet Sci Pract. 2025 Feb;75:103241. doi: 10.1016/j.msksp.2024.103241. Epub 2024 Nov 30.
QUESTION(S): What are the prognostic reasoning practices of physiotherapists towards musculoskeletal disorders?
Exploratory phenomenological study.
15 physiotherapists who currently treat musculoskeletal disorders.
Semi-structured interviews were implemented to collect data which was analysed using an inductive coding and thematic analysis approach.
Three themes were identified. First, how physiotherapists considered prognosis within clinical practice. Whilst prognosis is an important consideration, in some circumstances it either may not be considered or is implied. Second, how physiotherapists determine prognosis for musculoskeletal disorders. Several factors shaped the ability of physiotherapists to determine prognosis including how they determine prognosis, and the barriers and facilitators towards determining prognosis. Finally, how physiotherapists discuss prognosis with individuals who have a musculoskeletal disorder. These discussions were shaped by the prognostic information provided, as well as the barriers and facilitators towards discussing prognosis.
The prognostic reasoning of physiotherapists appears to be influenced initially by whether they consider it or not. It is then shaped by both barriers and facilitators towards determining and discussing prognosis. Facilitators for this prognostic reasoning process appear to be aligned with the biomedical model of health, whilst barriers more aligned with psychosocial factors. To improve prognostic reasoning, physiotherapists should continue to strive to conceptualize prognosis within a biopsychosocial framework. Doing so will improve the ability of physiotherapists to prognosticate, which will subsequently improve outcomes associated with musculoskeletal disorders.
物理治疗师对肌肉骨骼疾病的预后推理实践是怎样的？
探索性现象学研究。
15名目前治疗肌肉骨骼疾病的物理治疗师。
采用半结构化访谈收集数据，并使用归纳编码和主题分析方法进行分析。
确定了三个主题。第一，物理治疗师在临床实践中如何考虑预后。虽然预后是一个重要的考虑因素，但在某些情况下可能不会被考虑或只是隐含的。第二，物理治疗师如何确定肌肉骨骼疾病的预后。几个因素影响了物理治疗师确定预后的能力，包括他们如何确定预后以及确定预后的障碍和促进因素。最后，物理治疗师如何与患有肌肉骨骼疾病的个体讨论预后。这些讨论受到所提供的预后信息以及讨论预后的障碍和促进因素的影响。
物理治疗师的预后推理似乎最初受到他们是否考虑预后的影响。然后，它受到确定和讨论预后的障碍和促进因素的影响。这种预后推理过程的促进因素似乎与生物医学健康模型一致，而障碍则更多地与心理社会因素一致。为了改善预后推理，物理治疗师应继续努力在生物心理社会框架内对预后进行概念化。这样做将提高物理治疗师的预后能力，进而改善与肌肉骨骼疾病相关的结果。
