Brinkman Niels, Ludden Rebecca, Azarpey Ali, Doornberg Job N, Ring David, Jayakumar Prakash
Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas, Austin, TX, USA.
Department of Orthopaedic & Trauma Surgery, University Medical Center, Groningen, the Netherlands.
J Patient Exp. 2025 Sep 5;12:23743735251376078. doi: 10.1177/23743735251376078. eCollection 2025.
Among 203 patients presenting for musculoskeletal specialty care between November 2023 and January 2024, we measured the relationship of openness to mindset exercises such as cognitive behavioral therapy (training the mind to default to healthier thoughts and feelings about bodily sensations) with levels of personal health agency accounting for other personal factors. Factors associated with greater openness to mindset exercises in linear regression included greater personal health agency (RC = 0.17), younger age (RC = -0.030), and 4-year college education (RC = 1.5). In a second linear regression, greater personal health agency was associated with older age (RC = 0.053), greater trust in the clinician (RC = 0.25), injury diagnosis (RC = 1.8), less distress regarding symptoms (RC = -0.25), less unhelpful thinking regarding symptoms (RC = -0.43), and retirement (RC = -1.7). In cluster analysis, we found that increasingly lower openness to mindset exercises was associated with increasingly worse levels of distress and unhelpful thoughts, lower personal health agency, and slightly varying social health and trust in clinician. The finding that greater responsibility for one's health, including openness to mindset exercises, corresponds with a healthy understanding and emotional response to bodily sensations, greater social security, and greater trust in the clinician directs specialists to prioritize building trust, gently reorienting common misconceptions about bodily sensations, and assistance with social stressors.
在2023年11月至2024年1月期间前来接受肌肉骨骼专科护理的203名患者中，我们测量了对认知行为疗法等思维方式练习（训练思维默认对身体感觉产生更健康的想法和感受）的接受程度与考虑其他个人因素后的个人健康能动性水平之间的关系。线性回归中与对思维方式练习接受程度更高相关的因素包括更高的个人健康能动性（相关系数RC = 0.17）、更年轻的年龄（RC = -0.030）以及四年制大学教育（RC = 1.5）。在第二次线性回归中，更高的个人健康能动性与更高的年龄（RC = 0.053）、对临床医生更高的信任度（RC = 0.25）、损伤诊断（RC = 1.8）、对症状更少的困扰（RC = -0.25）、对症状更少的无益思维（RC = -0.43）以及退休（RC = -1.7）相关。在聚类分析中，我们发现对思维方式练习的接受程度越来越低与越来越严重的困扰和无益思维水平、更低的个人健康能动性以及略有不同的社会健康状况和对临床医生的信任度相关。对自身健康承担更大责任，包括对思维方式练习的接受程度，与对身体感觉的健康理解和情绪反应、更高的社会保障以及对临床医生更高的信任度相关，这一发现指导专科医生优先建立信任、温和地纠正对身体感觉的常见误解，并帮助应对社会压力源。
