Communicating safety-netting information in primary care physiotherapy consultations for people with low back pain

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2024-09-19 DOI:10.1016/j.msksp.2024.103192

Christopher Horler , Geraldine Leydon , Lisa Roberts

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引用次数: 0

Abstract

Background

Safety-netting involves communicating information to patients about diagnostic uncertainty, the likely time-course of their condition and how to appropriately seek help from a healthcare professional if their condition persists or worsens. Little is known about how physiotherapists communicate safety-netting information to people with low back pain (LBP).

Objectives

This research aimed to use a Safety-Netting Coding Tool (SaNCoT) to explore how physiotherapists communicate safety-netting information to people with LBP.

Methods

The SaNCoT was used to conduct a secondary analysis of audio-recordings and transcripts from 79 primary care physiotherapy consultations (41 initial and 38 follow-up) involving 12 physiotherapists and 41 patients with LBP in Southern England. Quantitative data from the SaNCoT were analysed descriptively.

Findings

The study found evidence of diagnostic uncertainty in 53 (67%) appointments and no examples of physiotherapists providing patients with specific information about their condition time-course. Eight patients were given safety-netting advice, but most (57.9%, n = 11) episodes of safety-netting advice did not include specific signs and symptoms for patients to monitor. Potential missed opportunities for safety-netting advice were identified in 19 appointments (24.1%) which tended to relate to the patient's associated leg symptoms but also included possible serious pathology.

Conclusion

The SaNCoT was successfully used to measure safety-netting communication within physiotherapy consultations and found missed opportunities for providing clear safety-netting advice. Physiotherapists can use the findings to reflect on how they can provide clear safety-netting information to patients with LBP to effectively support patients to self-manage and help them seek appropriate care if their condition deteriorates.

查看原文本刊更多论文

在初级保健物理治疗咨询中为腰背痛患者传达安全网信息。

背景：安全网涉及向患者传达有关诊断不确定性、病情可能的时间进程以及在病情持续或恶化时如何适当寻求医疗保健专业人员帮助的信息。人们对物理治疗师如何向腰背痛患者传达安全网信息知之甚少：本研究旨在使用安全网编码工具（SaNCoT）探讨物理治疗师如何向腰背痛患者传达安全网信息：方法：使用 SaNCoT 对 79 次初级保健物理治疗咨询（41 次初诊和 38 次复诊）的录音和文字记录进行二次分析，涉及英格兰南部的 12 名物理治疗师和 41 名枸杞多糖症患者。对来自 SaNCoT 的定量数据进行了描述性分析：研究发现，53 次（67%）会诊存在诊断不确定性，物理治疗师未向患者提供有关其病情时间进程的具体信息。八名患者获得了安全网建议，但大多数（57.9%，n = 11）安全网建议并不包括患者需要监测的具体体征和症状。在19次预约（24.1%）中发现了可能错失的安全网建议机会，这些建议往往与患者相关的腿部症状有关，但也包括可能的严重病变：SaNCoT被成功地用于测量物理治疗咨询中的安全网沟通，并发现了在提供明确的安全网建议方面所错失的机会。物理治疗师可利用研究结果反思如何为腰椎间盘突出症患者提供清晰的安全网信息，以有效支持患者进行自我管理，并在病情恶化时帮助他们寻求适当的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.