Embedding Psychosocial Perspectives Within Clinical Management of Low Back Pain: Integration of Psychosocially Informed Management Principles Into Physical Therapist Practice-Challenges and Opportunities
Embedding Psychosocial Perspectives Within Clinical Management of Low Back Pain: Integration of Psychosocially Informed Management Principles Into Physical Therapist Practice-Challenges and Opportunities
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DOI：
10.2522/ptj.20100326
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发表时间：
2011-05-01
期刊：
影响因子：
3.2
通讯作者：
Delitto, Anthony
中科院分区：
文献类型：
--
作者：
Foster, Nadine E.;Delitto, Anthony
随着人们对健康的生物心理社会模型的了解越来越多，很明显，腰痛的物理和生物医学特征与伴随出现的心理和社会因素之间存在复杂的相互依赖的关系。流行病学研究不仅强调了心理和社会因素与背痛和残疾有关，而且还揭示了这些因素作为预后指标或康复障碍的方式，预测哪些患者预后不良。将这些障碍的评估整合到物理治疗师的实践中，并利用这些信息来指导临床决策，有可能通过提高治疗对个人的针对性，增强治疗师与患者的关系以及对管理建议和治疗计划的坚持来提高物理治疗师提供的护理质量。反过来，这些方法可以改善患者的临床结果和提供服务的效率和有效性，帮助直接干预需要他们的人。本文总结了在物理治疗师实践中为腰痛患者嵌入心理社会观点的主要挑战以及通过这样做可以实现的机会，并强调了研究，临床实践和教育的新发展，这些发展正在塑造该领域的未来方向。
As the biopsychosocial model of health has become increasingly understood, it has become clear that there are complex, interdependent relationships between the physical and biomedical features of low back pain and the psychological and social factors that present concomitantly. Epidemiological studies have not only highlighted that psychological and social factors are associated with back pain and disability but also have shed light on the way in which these factors serve as prognostic indicators, or obstacles to recovery, predicting which patients will have a poor prognosis. Integrating the assessment of these obstacles to recovery into physical therapist practice and using this information to guide clinical decision making have the potential to improve the quality of care offered by physical therapists by improving the targeting of treatments to individuals and enhancing the therapist-patient relationship and adherence to management advice and treatment programs. In turn, such approaches may improve both patients' clinical outcomes and the efficiency and effectiveness of service provision, helping direct interventions to those who need them. This article summarizes the key challenges to embedding psychosocial perspectives within physical therapist practice for patients with low back pain and the opportunities that could be realized by doing so, and it highlights new developments in research, clinical practice, and education that are shaping future directions in this field.