What are Brazilian orthopaedists' views on the diagnosis and treatment of patients with chronic nonspecific low back pain? A qualitative investigation.

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2023-12-01 Epub Date: 2023-05-16 DOI:10.1002/msc.1778
Fabiana Silveira Murray, Nathalia Costa, Fabianna Jesus-Moraleida, Ney Meziat-Filho
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Abstract

Background: Orthopaedists are often the first point of contact for patients who present with low back pain (LBP) and chronic LBP in Brazil.

Aim: To explore the views of orthopaedists on therapeutic approaches for chronic non-specific low back pain (CNLBP) with a view to gain insights into aspects of clinical practice considered important to them.

Methods: A qualitative design underpinned by interpretivism was employed. Participants were (n = 13) orthopaedists with experience in treating patients with CNLBP. Following the pilot interviews, semi-structured interviews were conducted, audio-recorded, transcribed and de-identified. Interview data were thematically analysed.

Results: Four themes were identified. (1) Biophysical aspects are important and predominate, but sometimes their relevance can be unclear; (2) Psychosocial aspects and lifestyle factors influence the therapeutic approach; (3) Treatment of CNLBP - including medication, physical activity, surgery and other invasive procedures and other therapeutic modalities; and (4) Nuances of clinical practice - "it goes beyond medicine".

Conclusion: Brazilian orthopaedists value identifying the biophysical cause(s) of chronic low back pain. Psychological factors were often discussed secondary to biophysical aspects, whereas social aspects were rarely mentioned. Orthopaedists highlighted their difficulties in navigating patients' emotions and reassuring patients without referrals to imaging tests. Orthopaedists may benefit from training that targets communication and other relational aspects of care in order to work with people who present with CNLBP.

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巴西骨科医生对慢性非特异性腰背痛患者的诊断和治疗有何看法?一项定性调查。
背景:目的:探讨骨科医生对慢性非特异性腰背痛(CNLBP)治疗方法的看法,以期深入了解他们认为重要的临床实践方面:方法:采用以解释学为基础的定性设计。参与者为(n = 13)具有治疗 CNLBP 患者经验的骨科医生。在试点访谈之后,进行了半结构化访谈、录音、转录和去身份化。对访谈数据进行了主题分析:结果:确定了四个主题。(1) 生物物理方面非常重要且占主导地位,但有时其相关性可能不明确;(2) 社会心理方面和生活方式因素影响治疗方法;(3) CNLBP 的治疗--包括药物治疗、体育锻炼、手术和其他侵入性程序以及其他治疗方式;(4) 临床实践的细微差别--"它超越了医学":巴西骨科医生重视找出慢性腰背痛的生物物理原因。对心理因素的讨论往往次于生物物理因素,而社会因素则很少被提及。矫形外科医生强调,他们难以驾驭患者的情绪,也难以在不转诊进行影像学检查的情况下安抚患者。矫形外科医生可能会受益于针对沟通和其他护理关系方面的培训,以便与出现 CNLBP 的患者合作。
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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