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Hand therapists' knowledge and practice-related beliefs about pain science: A survey study
Brocha Z Stern1, Tsu-Hsin Howe1
1Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA.
Introduction:
Identifying hand therapists' knowledge and beliefs about pain can illuminate familiarity with modern pain science within hand therapy.
Purpose Of The Study:
The primary aim was to identify hand therapists' knowledge of pain neurophysiology. Secondary purposes were to explore demographic variation in knowledge, describe practice-related beliefs about pain science, and explore associations between knowledge and beliefs.
Study Design:
Cross-sectional descriptive survey study.
Methods:
An electronic survey, including the Revised Neurophysiology of Pain Questionnaire (R-NPQ) and Likert-type questions about practice-related beliefs, was distributed to American Society of Hand Therapists members.
Results:
Data from 305 survey responses were analyzed. R-NPQ accuracy ranged from 42% to 100%, with a mean of 75% (9/12 ± 1.5). Certified hand therapists scored, on average, 0.8 points lower than their noncertified peers. Participants with a doctoral degree scored 0.7 or 0.6 points higher, respectively, than those with a bachelor's or master's degree. Objective knowledge of pain neurophysiology was positively associated with perceived knowledge of pain science (ρ = .31, P < .001). Associations between R-NPQ and perceived importance of knowing pain science; confidence in pain-related evaluation, treatment, and education; and frequency of incorporating pain science principles into practice were small but statistically significant (ρ = .12-.25, P = <.001-.04).
Conclusions:
Although hand therapists recognized the importance of knowing pain science, they had objective and subjective limitations in that knowledge. Specific errors in their R-NPQ responses suggest misconceptions related to the modern differentiation between nociception and pain. Blurring of these constructs may relate to participants' self-reported practice emphasis on acute versus chronic conditions. Future studies should explore knowledge, attitudes, and beliefs about pain beyond R-NPQ scores to understand variation in practice and training needs.
