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首页> 外文期刊>BMC Family Practice >What influences general practitioners’ use of exercise for patients with chronic knee pain? Results from a national survey
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What influences general practitioners’ use of exercise for patients with chronic knee pain? Results from a national survey

机译：是什么影响全科医生对慢性膝关节疼痛患者进行运动？全国调查结果

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Background Exercise is a recommended ‘core’ treatment for chronic knee pain (CKP), however it appears to be underused by general practitioners (GPs). While behavioural theories suggest that attitudes and beliefs influence behaviours, no single theory reliably predicts GPs’ behaviours. A theoretical analysis framework, developed from sociocognitive theories, was used to underpin investigation of the key influences associated with GPs’ use of exercise for patients with CKP, to inform future interventions to optimise GPs’ use of exercise. Methods A cross-sectional postal questionnaire survey investigated UK GPs’ reported use of exercise based on a patient case vignette. Factors influencing GPs’ exercise use (behaviour) were examined using attitude statements, free-text questions and multiple response option questions related to factors within the analysis framework. Unadjusted logistic regression analyses explored the associations between GPs’ attitudes/beliefs and behaviour. Results From a total sample of 5000 GPs, 835 (17%) returned a questionnaire. Most respondents ( n =?729, 87%) reported that they would use exercise. Factors significantly associated with exercise use (OR (95% CI)) included GPs’ beliefs about their role (belief that GPs should give information on type, duration and frequency of exercise (30.71 (5.02,188.01)), beliefs about consequences (agreement that knee problems are improved by local (3.23 (1.94,5.39)) and general exercise (2.63 (1.38,5.02))), moral norm (agreement that GPs should prescribe all patients local (3.08 (1.96,4.83)) and general exercise (2.63 (1.45,4.76))), and GP-related beliefs about capabilities (prior experience of insufficient expertise to give detailed exercise information (0.50 (0.33,0.76)). Whilst perceived time limitations were not associated with exercise use (1.00 (0.33,3.01)), GPs who disagreed that they experienced time limitations were more likely to suggest general (2.17 (1.04,4.55)), or demonstrate local (2.16 (1.06,4.42)), exercises. Conclusion GPs’ attitudes and beliefs are associated with their use of exercise for patients with CKP, particularly beliefs about role, responsibilities and skills in initiating exercise, and about the efficacy of exercise. Although the low response risks response bias, these results can inform future interventions to optimise GPs’ behaviour. The role of GP uncertainty and influences on clinical decision-making need further exploration, thus an amended analysis framework is suggested, which should be tested in future research.
机译：背景运动是慢性膝关节疼痛（CKP）的推荐“核心”治疗方法，但似乎没有被全科医生（GPs）使用。尽管行为理论表明态度和信念会影响行为，但没有任何一个理论能够可靠地预测GP的行为。从社会认知理论发展而来的理论分析框架被用于支持对全科医生使用运动对CKP患者的关键影响进行调查，以为将来的干预措施提供参考，以优化全科医生对运动的使用。方法横断面邮政问卷调查调查了英国全科医生报告的根据患者病例插图使用运动的情况。使用态度陈述，自由文本问题以及与分析框架内的因素相关的多项回答选项问题，研究了影响GP锻炼使用（行为）的因素。未经调整的逻辑回归分析探讨了全科医生的态度/信念与行为之间的关联。结果在总共5000名GP中，有835名（17％）返回了问卷。大多数受访者（n =？729，87％）报告说他们会使用运动。与运动使用（OR（95％CI））显着相关的因素包括全科医生对其角色的信念（相信全科医生应提供有关运动的类型，持续时间和频率的信息（30.71（5.02,188.01）），对后果的信念（协议）局部（3.23（1.94,5.39））和普通运动（2.63（1.38,5.02）），道德规范（同意全科医生应规定所有患者局部（3.08（1.96,4.83））以及普通运动可以改善膝盖问题（2.63（1.45,4.76））），以及与GP有关的能力信念（以前经验不足，无法提供详细的锻炼信息（0.50（0.33,0.76））。而感知的时间限制与锻炼的使用无关（1.00（ 0.33,3.01）），不同意自己经历时间限制的GP更有可能建议进行一般（2.17（1.04,4.55））或表现出局部（2.16（1.06,4.42））锻炼。与CKP，尤其是bel病人的运动有关关于发起锻炼的角色，责任和技能以及锻炼功效的想法。尽管低响应风险会带来响应偏差，但这些结果可以为将来的干预提供参考，以优化全科医生的行为。 GP不确定性的作用及其对临床决策的影响需要进一步探索，因此提出了一个经过修订的分析框架，应在以后的研究中对其进行检验。

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