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在瑞典的初级卫生保健中,哪些因素与物理治疗师在管理腰痛患者时使用患者报告的结局指标相关?

What factors are associated with physical therapists' use of patient-reported outcome measures in managing patients with low back pain in primary health care in Sweden?

作者信息

Melbye Christine, Östhols Sara, von Rosen Philip, Rasmussen-Barr Eva

机构信息

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physical therapy, Alfred Nobels Allé 23, 141 83 Huddinge, Stockholm Sweden.

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physical therapy, Alfred Nobels Allé 23, 141 83 Huddinge, Stockholm Sweden.

出版信息

Braz J Phys Ther. 2025 Aug 12;29(6):101250. doi: 10.1016/j.bjpt.2025.101250.

Abstract

BACKGROUND

Physical therapists' use of patient-reported outcome measures (PROMs) in managing patients with low back pain (LBP) is reportedly low, especially for health-related and psychosocial factors.

OBJECTIVE

To investigate factors associated with using specific PROMs among physical therapists working in primary care.

METHODS

We analyzed data collected from physical therapists (n = 1237). Logistic regression analyses (Odd Ratios (OR), 95 % Confidence Intervals) were conducted to investigate how using PROMs for pain, disability, health-related, and psychosocial factors is associated with the physical therapists' demographic characteristics, including educational levels.

RESULTS

Most physical therapists used PROMs for pain (83 %), while PROMs for disability (28 %), health-related (14 %), and psychosocial factors (13 %) were used less frequently. Being female (OR 2.57, 95 % CI: 1.84, 3.59) and working in private clinics (OR 1.83, 95 % CI: 1.27, 2.67) were associated with using PROMs for pain. Holding a master's degree or PhD was linked to using PROMs for disability (OR 1.85, 95 % CI: 1.28, 2.66) and psychosocial factors (OR 2.11, 95 % CI: 1.19, 3.65). Being female (OR 1.51, 95 % CI 1.01, 2.29) and being an advanced clinical specialist (OR 2.09, 95 % CI: 1.29, 3.33) were associated with using PROMs for health-related factors.

CONCLUSIONS

While physical therapists commonly use PROMs for pain, few use them to assess health-related and psychosocial factors. Those with higher educational levels or advanced clinical specialists are more likely to incorporate such PROMs in managing patients with LBP. Future studies should explore educational interventions to improve understanding of PROMs and their role in clinical reasoning within a biopsychosocial framework.

摘要

背景

据报道,物理治疗师在管理腰痛(LBP)患者时对患者报告结局测量指标(PROMs)的使用频率较低,尤其是在涉及健康相关和心理社会因素方面。

目的

调查在初级保健机构工作的物理治疗师使用特定PROMs的相关因素。

方法

我们分析了从物理治疗师(n = 1237)收集的数据。进行逻辑回归分析(比值比(OR),95%置信区间),以研究使用PROMs评估疼痛、残疾、健康相关和心理社会因素与物理治疗师的人口统计学特征(包括教育水平)之间的关联。

结果

大多数物理治疗师使用PROMs评估疼痛(83%),而用于评估残疾(28%)、健康相关因素(14%)和心理社会因素(13%)的PROMs使用频率较低。女性(OR 2.57,95% CI:1.84,3.59)以及在私人诊所工作(OR 1.83,95% CI:1.27,2.67)与使用PROMs评估疼痛相关。拥有硕士学位或博士学位与使用PROMs评估残疾(OR 1.85,95% CI:1.28,2.66)和心理社会因素(OR 2.11,95% CI:1.19,3.65)有关。女性(OR 1.51,95% CI 1.01,2.29)以及高级临床专家(OR 2.09,95% CI:1.29,3.33)与使用PROMs评估健康相关因素有关。

结论

虽然物理治疗师普遍使用PROMs评估疼痛,但很少用其评估健康相关和心理社会因素。教育水平较高者或高级临床专家更有可能在管理LBP患者时纳入此类PROMs。未来的研究应探索教育干预措施,以增进对PROMs及其在生物心理社会框架内临床推理中作用的理解。

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