Peterson Seth, Halpert Brett, Heick John D
Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, USA.
The Motive, Oro Valley, AZ, USA.
J Man Manip Ther. 2025 Apr;33(2):142-148. doi: 10.1080/10669817.2024.2438182. Epub 2024 Dec 13.
Rising surgical rates for lumbar spinal stenosis (LSS) and underutilization of physical therapist services for this condition may increase patient risks and healthcare costs. Patient beliefs may also contribute to this problem. Therefore, our objective was to determine which messages about physical therapy were perceived as strongest by patients with LSS and whether those messages were influenced by patient factors.
The study used a cross-sectional survey design, and participants were patients of outpatient physical therapy clinics with imaging or clinical evidence of LSS. Participants completed an electronic survey containing different messages about physical therapist services for LSS. Messages were designed using the health belief model. Perceived message strength was scored using the perceived argument strength scale (PASS). Pain catastrophizing and pain self-efficacy were measured to determine whether they influenced participant perceptions. Occurrence of magnetic resonance imaging and surgical consultations were also measured.
Of 189 potential participants, 101 were included in the study. The message perceived as strongest emphasized physical therapists as listeners who would customize a plan (PASS 36.1 [5.0]) Similar scores were seen for messages that emphasized benefits of education and self-management and de-emphasized severity. The message that emphasized research findings was rated the least strong. Participants who had high levels of pain catastrophizing were more likely to have had imaging and perceived arguments as less strong.
DISCUSSION/CONCLUSION: Results of the current study suggested patients with LSS preferred a message that emphasized physical therapists as listeners who would customize a plan. The message about research outcomes was perceived as the least strong. Therefore, awareness campaigns intended to influence the beliefs or behavior of patients with LSS should emphasize the individualized nature of physical therapy more than research evidence.
腰椎管狭窄症（LSS）手术率不断上升，而针对该病症物理治疗师服务利用不足，这可能会增加患者风险和医疗成本。患者的观念也可能导致这一问题。因此，我们的目标是确定LSS患者认为哪种关于物理治疗的信息最具说服力，以及这些信息是否受到患者因素的影响。
本研究采用横断面调查设计，参与者为门诊物理治疗诊所中具有LSS影像学或临床证据的患者。参与者完成了一项电子调查，其中包含关于LSS物理治疗师服务的不同信息。这些信息是根据健康信念模型设计的。使用感知论据强度量表（PASS）对感知信息强度进行评分。测量疼痛灾难化和疼痛自我效能感，以确定它们是否影响参与者的认知。还测量了磁共振成像和手术咨询的发生率。
在189名潜在参与者中，101名被纳入研究。被认为最具说服力的信息强调物理治疗师是会制定个性化计划的倾听者（PASS 36.1 [5.0]）。强调教育和自我管理益处并淡化病情严重程度的信息得分相似。强调研究结果的信息被评为最缺乏说服力。疼痛灾难化程度高的参与者更有可能进行过影像学检查，并且认为论据的说服力较弱。
讨论/结论：本研究结果表明，LSS患者更喜欢强调物理治疗师是会制定个性化计划的倾听者的信息。关于研究结果的信息被认为最缺乏说服力。因此，旨在影响LSS患者信念或行为的宣传活动应更多地强调物理治疗的个性化性质，而不是研究证据。
