Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Yannick Tousignant-Laflamme
{"title":"颈部疼痛的康复管理-基于疼痛和残疾驱动因素管理模型的诊断框架的发展。","authors":"Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Yannick Tousignant-Laflamme","doi":"10.1111/jep.14299","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Rationale</h3>\n \n <p>Neck pain is a major cause of disability worldwide, and current rehabilitation strategies show limited effectiveness. Subgrouping patients by their primary pain and disability drivers can help tailor treatments. At this end, the Pain and Disability Drivers Management (PDDM) was developed and has demonstrated preliminary effectiveness in the management of low back pain. Nevertheless, the PDDM model was only validated for this population. Adapting this framework to patients with neck pain would provide a more global view of the patient's experience of pain and support a genuine biopsychosocial intervention.</p>\n </section>\n \n <section>\n \n <h3> Aims and Objectives</h3>\n \n <p>The aim of this study was to develop and validate the content of the PDDM model for patients living with neck pain.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Through a modified DELPHI study design, participants with clinical and research expertize in rehabilitation of neck pain were invited to participate. A questionnaire was developed using literature reviews and endorsed by a steering committee. The relevance of each element of the newly adapted model was evaluated on a 4-point Likert scale. An item reached consensus if it obtained the predefined threshold of > 78% “relevant” and “very relevant.” Participants left comments on terminology and recommended items to add in early rounds. Quantitative and qualitative analyses were performed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>An invitation was sent to 1650 potential participants, from which 155 accessed the survey, 64 completed the first round and 55 the second round. A total of 70 elements met consensus and were distributed across six domains: “Nociceptive pain drivers”, “nociplastic pain drivers,” “drivers associated with neuropathic pain”, “comorbidity drivers”, “cognitive-emotional drivers” and “environmental or lifestyle drivers, and social determinants of health.”</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Through a modified DELPHI study, the PDDM model was updated and adapted to people with neck pain. Subsequent steps include clinical integration and measures of efficacy when used for assessment/treatment.</p>\n </section>\n </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.14299","citationCount":"0","resultStr":"{\"title\":\"Rehabilitation Management of Neck Pain—Development of a Diagnostic Framework Based on the Pain and Disability Drivers Management Model\",\"authors\":\"Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Yannick Tousignant-Laflamme\",\"doi\":\"10.1111/jep.14299\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Rationale</h3>\\n \\n <p>Neck pain is a major cause of disability worldwide, and current rehabilitation strategies show limited effectiveness. Subgrouping patients by their primary pain and disability drivers can help tailor treatments. At this end, the Pain and Disability Drivers Management (PDDM) was developed and has demonstrated preliminary effectiveness in the management of low back pain. Nevertheless, the PDDM model was only validated for this population. Adapting this framework to patients with neck pain would provide a more global view of the patient's experience of pain and support a genuine biopsychosocial intervention.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims and Objectives</h3>\\n \\n <p>The aim of this study was to develop and validate the content of the PDDM model for patients living with neck pain.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Through a modified DELPHI study design, participants with clinical and research expertize in rehabilitation of neck pain were invited to participate. A questionnaire was developed using literature reviews and endorsed by a steering committee. The relevance of each element of the newly adapted model was evaluated on a 4-point Likert scale. An item reached consensus if it obtained the predefined threshold of > 78% “relevant” and “very relevant.” Participants left comments on terminology and recommended items to add in early rounds. Quantitative and qualitative analyses were performed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>An invitation was sent to 1650 potential participants, from which 155 accessed the survey, 64 completed the first round and 55 the second round. 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Rehabilitation Management of Neck Pain—Development of a Diagnostic Framework Based on the Pain and Disability Drivers Management Model
Rationale
Neck pain is a major cause of disability worldwide, and current rehabilitation strategies show limited effectiveness. Subgrouping patients by their primary pain and disability drivers can help tailor treatments. At this end, the Pain and Disability Drivers Management (PDDM) was developed and has demonstrated preliminary effectiveness in the management of low back pain. Nevertheless, the PDDM model was only validated for this population. Adapting this framework to patients with neck pain would provide a more global view of the patient's experience of pain and support a genuine biopsychosocial intervention.
Aims and Objectives
The aim of this study was to develop and validate the content of the PDDM model for patients living with neck pain.
Methods
Through a modified DELPHI study design, participants with clinical and research expertize in rehabilitation of neck pain were invited to participate. A questionnaire was developed using literature reviews and endorsed by a steering committee. The relevance of each element of the newly adapted model was evaluated on a 4-point Likert scale. An item reached consensus if it obtained the predefined threshold of > 78% “relevant” and “very relevant.” Participants left comments on terminology and recommended items to add in early rounds. Quantitative and qualitative analyses were performed.
Results
An invitation was sent to 1650 potential participants, from which 155 accessed the survey, 64 completed the first round and 55 the second round. A total of 70 elements met consensus and were distributed across six domains: “Nociceptive pain drivers”, “nociplastic pain drivers,” “drivers associated with neuropathic pain”, “comorbidity drivers”, “cognitive-emotional drivers” and “environmental or lifestyle drivers, and social determinants of health.”
Conclusion
Through a modified DELPHI study, the PDDM model was updated and adapted to people with neck pain. Subsequent steps include clinical integration and measures of efficacy when used for assessment/treatment.
期刊介绍：
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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