Population based intervention to change back pain beliefs and disability: three part evaluation
Population based intervention to change back pain beliefs and disability: three part evaluation
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DOI：
10.1136/bmj.322.7301.1516
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发表时间：
2001-06-23
影响因子：
--
通讯作者：
Wyatt, M
中科院分区：
文献类型：
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作者：
Buchbinder, R;Jolley, D;Wyatt, M
目的评估一项以人群为基础的全州范围的公共卫生干预措施的有效性，该干预措施旨在改变对背痛的信念，影响医疗管理，减少残疾和赔偿费用。在对一般人口进行电话调查和对全科医生进行邮寄调查之前和之后，以邻近国家作为对照组，并对索赔进行描述性分析研究对象为澳大利亚两个州，调查对象为运动前和运动后两年半的普通人群4730人，比例为2：1：1; 2556名全科医生在运动开始前和运动开始后两年内主要结果测量背部信念问卷，关于背部疼痛的知识和态度陈述，工人因背部问题提出经济赔偿要求的发生率，结果在干预状态下，关于背痛的信念在连续的调查之间变得更加积极（问卷评分平均改善1.9（95%置信区间1.3至2.5），P< 0.001和3.2（2.6至3.9），P < 0.001，分别在基线与第二次和第三次调查之间）。医生对背痛的看法也有所改善。有一个明显的下降，背部疼痛的索赔，赔偿天数的比率，并在竞选期间的背部疼痛索赔的医疗支付campaign.Conclusions一个人口为基础的战略，提供有关背部疼痛的积极信息，提高人口和全科医生的信念，背部疼痛，似乎影响医疗管理和减少残疾和工人的赔偿费用与背部疼痛。
Objective To evaluate the effectiveness of a population based, state-wide public health intervention designed to alter beliefs about back pain, influence medical management, and reduce disability and costs of compensation.Design Quasi-experimental, non-randomised, non-equivalent, before and after telephone surveys of the general population and postal surveys of general practitioners with an adjacent state as control group and descriptive analysis of claims database.Setting Two states in Australia.Participants 4730 members of general population before and two and two and a half years after campaign started, in a ratio of 2:1:1; 2556 general Practitioners before and two years after campaign onsetMain outcome measures Back beliefs questionnaire, knowledge and attitude statements about back pain, incidence of workers' financial compensation claims for back problems, rate of days compensated, and medical payments for claims related to back pain and other claims.Results In the intervention state beliefs about back pain became more positive between successive surveys (mean improvement in questionnaire score 1.9 (95% confidence interval 1.3 to 2.5), P< 0.001 and 3.2 (2.6 to 3.9), P < 0.001, between baseline and the second and third survey, respectively). Beliefs about back pain also improved among doctors. There was a clear decline in number of claims for back pain, rates of days compensated, and medical payments for claims for back pain over the duration of the campaign.Conclusions A population based strategy of provision of positive messages about back pain improves population and general practitioner beliefs about back pain and seems to influence medical management and reduce disability and workers' compensation costs related to back pain.