在公共卫生保健系统中实施腰部疼痛自我管理方法
Ron Feldman1,2, Tamar Pincus3, Orna Reges4
1Department of Physiotherapy, Ariel University, Ariel, Israel.
JAMA network open
|January 8, 2026
概括
在公共卫生环境中,实施慢性腰部疼痛 (CLBP) 的增强型跨理论模型干预 (ETMI) 证明是可行的. 与常规护理相比,ETMI改善了患者的功能,并减少了与常规护理相比较少的会议的恐惧回避信念.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 物理疗法物理治疗
- 疼痛管理 疼痛管理
背景情况:
- 自主管理是慢性腰部疼痛 (CLBP) 推的第一线护理.
- 在大型公共卫生维护组织 (HMO) 中,结构化的自我管理模型未得到充分利用.
研究的目的:
- 评估在以色列公共HMO中实施增强型跨理论模型干预 (ETMI) 的可行性.
- 为了比较ETMI指导护理和CLBP患者的常规物理治疗之间的临床结果.
主要方法:
- 一项涉及ETMI培训的物理治疗师的队列研究,涉及公共HMO内的13家诊所.
- 在2022年1月至2023年7月期间从CLBP患者 (18岁以上) 收集的数据.
- ETMI是一种自我管理方法,强调放心,解决无助的信念,并促进身体活动,而不需要被动治疗或处方炼.
主要成果:
- 85.1%的受邀物理治疗师参加了ETMI培训,其中64.0%进行了干预.
- 17.0%的符合条件的CLBP患者接受了ETMI指导护理.
- 与常规护理相比,ETMI患者的功能 (aMD 3.3) 和恐惧回避信念 (aMD -4.3) 得到了更大的改善,疼痛减少程度相似,治疗次数更少 (aMD 1.3).
结论:
- 在公共HMO环境中实施ETMI是可行的.
- 与通常的物理治疗相比,ETMI与改善的患者结果和减少的治疗疗程有关.
- ETMI实施的范围有限,这表明需要进一步优化.
相关概念视频
Methods of Documentation VI: Case Management Model
852
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
852
Stress Prevention and Stress Management Techniques VI
235
Adopting a healthier lifestyle often requires overcoming significant challenges, but leveraging psychological, social, and cultural resources can facilitate meaningful change. Effective self-change hinges on understanding and applying key tools such as motivation and goal setting, which help sustain efforts toward long-term health benefits.
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
235
Methods Of Healthcare Delivery System
3.9K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.9K
Documentation in Long-Term and Home Healthcare Setting
1.4K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.4K
Community Based Intervention
269
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
269
Stress Prevention and Stress Management Techniques I
272
Stress prevention and management are crucial for maintaining well-being and building resilience. Techniques to manage stress include cultivating qualities like conscientiousness, a sense of personal control, and self-efficacy. Each of these traits significantly reduces stress and promotes healthier lifestyle choices and outcomes.
Conscientiousness
Conscientious individuals tend to be organized, responsible, and disciplined. They prioritize completing tasks and following structured routines,...
Conscientiousness
Conscientious individuals tend to be organized, responsible, and disciplined. They prioritize completing tasks and following structured routines,...
272


