Objective

The purpose of this study was to identify factors that influence a patient's decision to use physical therapy (PT) services for a low back pain (LBP) complaint.

Methods

Semi-structured qualitative phone interviews were conducted with patients who were offered an early outpatient PT visit secondary to patients’ primary appointment for LBP with a non-operative sports medicine specialist physician. Interviews were recorded, transcribed, and analyzed to identify themes using an iterative process.

Results

Forty participants were interviewed; 20 accepted early PT services, and 20 did not. Patients' decisions were influenced by perceived provider training, costs, doctor recommendations, wait times, symptoms, and a desire for a diagnosis. Patients preferred the care of non-operative sports medicine doctors over physical therapists for LBP due to their beliefs that favored doctors’ diagnosis and management of LBP. Patients perceived exercise as an effective treatment for back pain. Physical therapists were viewed as an adjunct service, despite positive comments about PT and the belief that exercise is one of the most effective treatments for LBP.

Conclusion

Barriers including costs, patient preferences, and knowledge about physical therapists limited patients' use of PT. Value-based care strategies aimed at improving the management of LBP increasingly promote the early use of PT. For these strategies to be effective, it is critical that patient perceptions and the influence of barriers on PT use are further understood. This study highlights the need to promote confidence in physical therapists’ expertise in the management and diagnosis of lower back pain.

中文翻译：

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患者使用物理疗法治疗腰痛：一项定性研究

客观的

本研究的目的是确定影响患者决定使用物理治疗 (PT) 服务治疗腰痛 (LBP) 的因素。

方法

对接受早期门诊 PT 就诊的患者进行了半结构化定性电话采访，这些患者主要是与非手术运动医学专科医生就诊 LBP。访谈被记录、转录和分析，以使用迭代过程确定主题。

结果

采访了 40 名参与者；20 人接受了早期 PT 服务，20 人没有接受。患者的决定受到感知的提供者培训、成本、医生建议、等待时间、症状和对诊断的渴望的影响。患者更喜欢非手术运动医学医生对 LBP 的护理而不是物理治疗师，因为他们相信医生对 LBP 的诊断和管理是有利的。患者认为运动是治疗背痛的有效方法。物理治疗师被视为一种辅助服务，尽管对 PT 有积极的评价，并且相信运动是 LBP 最有效的治疗方法之一。

结论

成本、患者偏好和对物理治疗师的了解等障碍限制了患者对 PT 的使用。旨在改善 LBP 管理的基于价值的护理策略越来越多地促进 PT 的早期使用。为了使这些策略有效，进一步了解患者的看法和障碍对 PT 使用的影响至关重要。这项研究强调需要提高人们对物理治疗师在腰痛管理和诊断方面的专业知识的信心。