BACKGROUND:Evidence points to clinicians' beliefs and practice behaviours related to low back pain (LBP), which are discordant with contemporary evidence. While interventions to align beliefs and behaviours with evidence among clinicians have demonstrated effectiveness, a more sustainable and cost-effective approach to positively developing workforce capacity in this area may be to target the emerging workforce. The aim of this study was to investigate beliefs and clinical recommendations for LBP, and their alignment to evidence, in Australian university allied health and medical students. METHODS:Final-year students in chiropractic, medicine, occupational therapy, pharmacy and physiotherapy disciplines in three Western Australian universities responded to a survey. Demographic data, LBP-related beliefs data [modified Health Care Providers Pain and Impact Relationship Scale (HC-PAIRS) and the Back Pain Beliefs Questionnaire (BBQ)] and activity, rest and work clinical recommendations for an acute LBP clinical vignette were collected. RESULTS:Six hundred two students completed the survey (response rate 74.6%). Cross-discipline differences in beliefs and clinical recommendations were observed (p > 0.001). Physiotherapy and chiropractic students reported significantly more helpful beliefs compared with the other disciplines, while pharmacy students reported the least helpful beliefs. A greater proportion of chiropractic and physiotherapy students reported guideline-consistent recommendations compared with other disciplines. HC-PAIRS and BBQ scores were strongly associated with clinical recommendations, independent to the discipline of study and prior experience of LBP. CONCLUSIONS:Aligning cross-discipline university curricula with current evidence may provide an opportunity to facilitate translation of this evidence into practice with a focus on a consistent, cross-discipline approach to LBP management.

译文

背景:证据表明临床医生的信念和与下腰痛(LBP)有关的行为,与现代证据不符。尽管在临床医生中采取干预措施使信念和行为与证据保持一致的做法已证明是有效的,但积极地发展该领域劳动力能力的更具可持续性和成本效益的方法可能是针对新兴劳动力。这项研究的目的是调查澳大利亚大学相关健康和医学专业学生对LBP的信念和临床建议,以及它们与证据的一致性。
方法:西澳大利亚州三所大学的脊骨疗法,医学,职业治疗,药学和物理疗法学科的大四学生对此进行了调查。收集了人口统计学数据,与LBP相关的信念数据[经修改的卫生保健提供者疼痛和影响关系量表(HC-PAIRS)和腰痛信念问卷(BBQ)]以及针对急性LBP临床小插图的活动,休息和工作的临床建议。
结果:602名学生完成了调查(回答率为74.6%)。观察到信念和临床建议的跨学科差异(p> 0.001)。与其他学科相比,理疗和脊骨疗法学生报告的帮助信念明显要多,而药学专业的学生报告的帮助信念最少。与其他学科相比,脊椎治疗和物理治疗学生中有更大比例的人报告了指南一致的建议。 HC-PAIRS和BBQ评分与临床建议密切相关,而与研究学科和LBP的既往经验无关。
结论:使跨学科的大学课程与当前的证据保持一致,可能会提供一个机会,以侧重于一致,跨学科的LBP管理方法为重点,将这一证据转化为实践。

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