使用行为科学评估肌肉骨成像通信干预措施:使用COM-B模型进行范围审查
Edward Kirby1, Andrew MacMillan2, Andrew Brinkley3
1School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK ed@edkirbyphysio.co.uk.
BMJ open
|April 9, 2025
概括
这次审查发现,改变临床医生如何向患者传达肌肉骨 (MSK) 影像检测结果的干预措施往往缺乏理论基础,并且影响有限. 未来的干预措施需要提高临床医生的知识和患者的信念,以改善沟通.
科学领域:
- 行为科学 行为科学
- 卫生沟通健康沟通
- 肌肉骨 (MSK) 成像成像
背景情况:
- 临床医生和患者经常将肌肉骨疼痛归因于正常的与年龄相关的成像发现,从而对结果产生负面影响并增加成本.
- 现有的干预措施,以改善MSK成像发现的沟通,显示了有限的成功.
- 需要一种行为科学框架来理解和改进这些干预措施.
研究的目的:
- 确定行为改变技术 (BCT),行为目标和旨在修改肌肉骨成像发现的沟通的干预措施的理论基础.
- 分析行为科学原则在当前干预中的应用.
主要方法:
- 使用能力,机会,动机 - 行为 (COM-B) 模型进行了范围审查.
- 从开始到2024年2月,在多个数据库 (MEDLINE,EMBASE,CINAHL,AMED,PsycINFO) 中进行了搜索.
- 包括涉及干预措施向患者和/或临床医生传达MSK成像发现的研究,但不包括严重MSK疾病的研究.
主要成果:
- 在2486项研究中,有11项研究确定了干预措施,使用了11种不同的BCT.
- 通常使用的BCT包括框架/重新框架,将对象添加到环境中,不兼容的信念和避免线索.
- 只有两项研究使用行为理论,大多数干预措施对疼痛,残疾或恐惧的影响最小.
结论:
- 值得注意的是,缺乏专注于临床医生的知识和有关MSK疼痛的患者资源的研究.
- 缺乏基于理论的设计可能解释了干预措施在向患者保证正常成像发现时的有限有效性.
- 未来的干预措施应优先提高临床医生的心理能力和临床医生/患者反思动机,以更有效地沟通MSK症状.
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