了解儿童肌肉骨骼疼痛物理治疗过程中治疗联盟的重要性:范围界定综述。

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2024-09-25 eCollection Date: 2024-01-01 DOI:10.3389/fpain.2024.1452771
Rhiannon Joslin, Eve Allen, Bernie Carter
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引用次数: 0

摘要

简介影响儿童的肌肉骨骼疼痛很常见。康复和治疗效果会受到多种个人和环境因素的影响。需要对儿童疼痛的物理治疗进行更严格的评估,确定特定技术的作用,并探讨治疗联盟的影响。本研究综述旨在研究:(1)儿童、家长和物理治疗师对肌肉骨骼疼痛治疗过程中治疗联盟的重要性有何看法?(2) 从儿童、家长和物理治疗师的角度看,儿童肌肉骨骼疼痛治疗过程中治疗联盟的主要特征是什么?范围界定综述以 Arksey 和 O'Malley 的框架为基础,以 PRISMA-ScR 为指导进行报告。检索策略基于三个概念块:(1) 研究人群:儿童(结果:在对最初的 236 篇文章进行重复删除和资格评估后,共收录了 9 篇文章;其中只有一篇文章专门探讨了治疗联盟问题,这也是唯一一篇直接提及治疗联盟的文章。所有九篇文章都介绍了儿童的经历。其中有一个总主题 "通过治疗联盟找到我内心的复原力 "和三个主要主题:"讨论:儿童、家长和物理治疗师都认为治疗联盟非常重要,它影响着儿童和家长对物理治疗的看法以及整体治疗效果。物理治疗师可以通过提供学科专业知识,与儿童建立联系和合作,成为他们值得信赖的向导,并通过帮助他们了解自己的身体、疼痛和康复时间表,共同绘制康复路线图,从而培养儿童在经历肌肉骨骼疼痛时的恢复能力。
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Understanding the importance of therapeutic alliance during physiotherapy treatment for musculoskeletal pain in children: a scoping review.

Introduction: Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain?

Methods: The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL.

Results: Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified.

Discussion: Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline.

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