Jaarsma Emily H, Azarpey Ali, Aronoff Drew, Ring David, Razi Amin
The Department of Surgery and Perioperative Care, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.
Chronic Stress (Thousand Oaks). 2025 Sep 24;9:24705470251382668. doi: 10.1177/24705470251382668. eCollection 2025 Jan-Dec.
Current patient-facing health information may unintentionally reinforce unhelpful and less adaptive mindsets regarding musculoskeletal symptoms. This prospective randomized trial evaluated the impact of psychologically-informed educational material, explicitly designed to promote healthier interpretations of bodily sensations according to cognitive science principles, on patient experience when compared to standard professional society materials.
In this trial, 133 adults presenting to an upper extremity specialist with one of eight common non-traumatic musculoskeletal conditions were randomly assigned to review health information produced by either: 1) a professional musculoskeletal society or 2) revised material created by the authors and psychologist collaborators. Participants completed surveys containing validated measures assessing personal health agency (PAM-13), perceived clinician empathy (JSPPPE) and emotional response to the material.
There were no significant differences based on the type of material reviewed. However, on multivariable analysis, participants diagnosed with rotator cuff tendinopathy, ganglion cyst, or carpal and cubital tunnel syndrome reported more negative emotional responses compared to those with lateral epicondylitis, regardless of the type of written material reviewed.
Cognitively-informed musculoskeletal health information was acceptable to patients but did not yield measurable improvements in emotional response, agency, or perceived empathy when compared to standard material. During the visit, diagnosis-specific factors may influence patient reactions more than information framing.
Patients find clear, accessible material designed to cultivate the healthiest possible interpretation of bodily sensations acceptable and non-distressing. Future interventions should explore diagnosis-specific tailoring of information or repeated exposure to impact outcomes.
II.
当前面向患者的健康信息可能会无意中强化对肌肉骨骼症状无益且适应性较差的思维模式。这项前瞻性随机试验评估了根据认知科学原理明确设计以促进对身体感觉进行更健康解读的心理知情教育材料与标准专业协会材料相比，对患者体验的影响。
在该试验中，133名因八种常见非创伤性肌肉骨骼疾病之一前来上肢专科医生处就诊的成年人被随机分配去查看以下两种材料之一：1）专业肌肉骨骼协会制作的健康信息，或2）作者与心理学家合作修订的材料。参与者完成了包含评估个人健康能动性（PAM - 13）、感知到的临床医生同理心（JSPPPE）以及对材料的情绪反应的有效测量指标的调查问卷。
根据所查看材料的类型没有显著差异。然而，在多变量分析中，与患有外侧上髁炎的参与者相比，被诊断为肩袖肌腱病、腱鞘囊肿或腕管和肘管综合征的参与者报告了更多负面情绪反应，无论所查看书面材料的类型如何。
从认知角度提供信息的肌肉骨骼健康信息患者是可以接受的，但与标准材料相比，在情绪反应、能动性或感知到的同理心方面并没有产生可测量的改善。在就诊期间，特定诊断因素可能比信息框架对患者反应的影响更大。
患者认为旨在培养对身体感觉最健康解读的清晰、易懂的材料是可以接受且不会令人困扰的。未来的干预措施应探索针对特定诊断的信息定制或反复接触以影响结果。
II级。
