Perceptions of physiotherapists towards the management of non-specific chronic low back pain from a biopsychosocial perspective: A qualitative study
Perceptions of physiotherapists towards the management of non-specific chronic low back pain from a biopsychosocial perspective: A qualitative study
复制标题
DOI：
10.1016/j.msksp.2018.10.006
复制
发表时间：
2018-12-01
影响因子：
2.3
通讯作者：
Murtagh, Ged
中科院分区：
文献类型：
--
作者：
Cowell, Ian;O'Sullivan, Peter;Murtagh, Ged
背景资料：物理治疗师已被敦促接受以患者为导向的生物心理社会（BPS）框架管理的非特异性慢性腰痛（NSCLBP）。然而，最近的证据表明，与常规护理相比，提供更广泛的BPS干预在疼痛或残疾方面表现出微小的差异。鲜为人知的是如何将BPS模型融入物理治疗practice.Objective的挑战：探讨物理治疗师的看法，在初级保健在英格兰采用BPS的方法来管理NSCLBP patients.Method：定性半结构化访谈进行了10个物理治疗师在初级保健工作。一个有目的的抽样方法，以寻求最广泛的观点。主位分析被用来分析访谈记录和捕捉emergencythemes.Results：三个主要主题出现：（1）物理治疗师认识到NSCLBP的多维度性质以及从BPS角度管理病情的必要性，（2）由于缺乏培训和指导，解决心理因素被视为具有挑战性，（3）促使患者自我管理他们的非小细胞肺癌是一个关键目标。虽然采用BPS方法是公认的物理治疗师在管理非小细胞肺癌，这项研究强调了实施基于证据的指南的问题，该指南建议解决心理因素，但提供有限的支持这个。它还支持需要分配更多的时间来探索这些领域的痛苦的人。让患者参与自我管理被视为一个关键目标，这不是一个简单的过程，需要仔细谈判。
Background: Physiotherapists have been urged to embrace a patient-oriented biopsychosocial (BPS) framework for the management of non-specific chronic low back pain (NSCLBP). However, recent evidence suggests that providing broader BPS interventions demonstrates small differences in pain or disability compared to usual care. Little is known about how to integrate a BPS model into physiotherapy practice and the challenges it presents.Objective: To explore the perceptions of physiotherapists' in primary care in England adopting a BPS approach to managing NSCLBP patients.Method: Qualitative semi-structured interviews were conducted with ten physiotherapists working in primary care. A purposive sampling method was employed to seek the broadest perspectives. Thematic analysis was used to analyse the interview transcripts and capture the emergent themes.Results: Three main themes emerged: (1) physiotherapists recognised the multi-dimensional nature of NSCLBP and the need to manage the condition from a BPS perspective, (2) addressing psychological factors was viewed as challenging due to a lack of training and guidance, (3) engaging patients to self-manage their NSCLBP was seen as a key objective.Conclusion: Although employing a BPS approach is recognised by physiotherapists in the management of NSCLBP, this study highlights the problems of implementing evidence based guidelines recommending that psychological factors be addressed but providing limited support for this. It also supports the need to allocate more time to explore these domains in distressed individuals. Engaging patients to self-manage was seen as a key objective, which was not a straightforward process, requiring careful negotiation.