Background

Prescription behavior in low back pain (LBP) differs between physical therapists with a biomedical versus a biopsychosocial belief, despite the presence of clinical guidelines.

Objective

To examine (1) the beliefs of physical therapy students and their adherence to clinical LBP guidelines in Belgium and the Netherlands; (2) whether the beliefs and attitudes of physical therapy students change during education; (3) whether beliefs are related to guideline adherence; (4) whether beliefs and attitudes differ with or without a personal history of LBP.

Methods

A cross-sectional design included students in the 2nd and 4th year of physical therapy education in 6 Belgian and 2 Dutch institutions. To quantify beliefs, the Pain Attitudes and Beliefs Scale, the Health Care Providers’ Pain and Impairment Relationship Scale, and a clinical case vignette were used.

Results

In total, 1624 students participated. (1) Only 47% of physical therapy students provide clinical guidelines’ consistent recommendations for activity and 16% for work. (2) 2nd year students score higher on the biomedical subscales and lower on the psychosocial subscale. 4th year students make more guideline consistent recommendations about work and activity. (3) Students with a more biopsychosocial belief give more guideline adherent recommendations. (4) Personal experience with LBP is not associated with different beliefs or attitudes.

Conclusions

A positive shift occurs from a merely biomedical model towards a more biopsychosocial model from the 2nd to the 4th year of physical therapy education. However, guideline adherence concerning activity and work recommendations remains low.

中文翻译：

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物理治疗教育中对腰痛的态度和信念：横断面研究

 背景

尽管存在临床指南，但具有生物医学信念和生物心理社会信念的物理治疗师在腰痛 (LBP) 方面的处方行为有所不同。

 客观的

检查( 1) 比利时和荷兰物理治疗学生的信念及其对临床 LBP 指南的遵守情况； （2）物理治疗学生的信念和态度在教育过程中是否发生变化； (3) 信念是否与准则的遵守有关； (4)无论是否有光体痛个人病史，信念和态度是否不同。

 方法

横断面设计包括 6 所比利时和 2 所荷兰机构的物理治疗教育第二年和第四年的学生。为了量化信念，使用了疼痛态度和信念量表、医疗保健提供者的疼痛和损害关系量表以及临床病例插图。

 结果

共有 1624 名学生参加。 (1) 只有 47% 的物理治疗专业学生提供临床指南一致的活动建议，16% 的学生提供工作建议。 (2) 二年级学生在生物医学分量表上得分较高，在心理社会分量表上得分较低。四年级学生对工作和活动提出更多符合指导方针的建议。 (3) 具有更多生物心理社会信念的学生会给出更多符合指南的建议。 (4)个人的光体痛经历与不同的信仰或态度无关。

 结论

从物理治疗教育的第二年到第四年，从单纯的生物医学模型转向更加生物心理社会的模型发生了积极的转变。然而，有关活动和工作建议的指南遵守率仍然很低。