Physiotherapists' telephone consultations regarding back pain: A method to analyze screening of risk factors
Physiotherapists' telephone consultations regarding back pain: A method to analyze screening of risk factors
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DOI：
10.3109/09593980903433938
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发表时间：
2010-10-01
影响因子：
2
通讯作者：
Asenlof, Pernilla
中科院分区：
文献类型：
--
作者：
Demmelmaier, Ingrid;Denison, Eva;Asenlof, Pernilla
背景和目的：在背痛长期残疾的危险因素的指南和临床管理之间存在差距。本研究的目的是：（1）评价一项研究方案的评估者间可靠性，该研究方案旨在分析电话咨询期间背痛长期残疾的身体和心理社会风险因素的筛查;（2）描述物理治疗师在电话咨询中评估的身体和心理社会风险因素的总体内容以及性质和程度，以诊断性筛查背痛患者。方法：材料包括17个最初的电话咨询有关背痛记录的五个物理治疗师。制定了一项涵盖八个循证风险因素的研究方案。三名评定者根据方案进行单独分析。结果：被调查的危险因素数量的组内相关性为0.82（p <0.001）。筛选的风险因素的Kappa值（成对）分别为0.79、0.73和0.66（p <0.001）。在每次咨询中筛选两个风险因素的中位数;最常见的是脊柱病理学/放射性疼痛的迹象，其次是病假，残疾，应对疼痛和消极信念。未筛选疼痛强度、抑郁和长期疼痛预期评分。结论：本方法可靠。它将被用于一项干预研究，评估物理治疗师在多大程度上可以学会在最初的电话咨询中按照指南进行筛查。
Background and aims: There is a gap between guidelines and clinical management of risk factors for prolonged disability in back pain. The aims of this study were to (1) evaluate the interrater reliability of a research protocol designed to analyze screening of physical and psychosocial risk factors for prolonged disability in back pain during telephone consultations; and (2) describe the overall content and the nature and extent of physical and psychosocial risk factors assessed by physiotherapists in telephone consultations for diagnostic screening of patients with back pain. Methods: The material consisted of 17 initial telephone consultations regarding back pain recorded by five physiotherapists. A research protocol covering eight evidence-based risk factors was developed. Three raters performed separate analyses according to the protocol. Results: Intraclass correlation of how many risk factors that were investigated was 0.82 (p < .001.) Kappa values (pairwise) of which risk factors that were screened were 0.79, 0.73, and 0.66 (p < .001). A median of two risk factors were screened in each consultation; most frequent was signs of spinal pathology/radiating pain, followed by sick leave, disability, coping with pain, and negative beliefs. Rating of pain intensity, depression, and expectations of longterm pain were not screened. Conclusions: The method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations.