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Ehrström J, Pöyhiä R, Kettunen J, Pyörälä E. What do Finnish physiotherapists and physiotherapy students know about the neurophysiology of pain? The Finnish version of the revised Neurophysiology of Pain Questionnaire. Physiother Theory Pract 2024; 40:828-842. [PMID: 36475565 DOI: 10.1080/09593985.2022.2154626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Understanding the concept of pain and its underlying biological mechanisms is an essential part of physiotherapists' professional knowledge. OBJECTIVES The first aim of the study was to translate and cross-culturally adapt the revised Neurophysiology of Pain Questionnaire into Finnish (RNPQ-FI) and to evaluate its reliability (internal consistency and test-retest reliability) in a sample of Finnish physiotherapists and physiotherapy students. The second aim was to compare the knowledge of pain neurophysiology between these two groups. METHODS Translation and cross-cultural adaptation followed the COSMIN Study Design checklist. Participants (202 physiotherapists and 97 physiotherapy students) completed an online survey containing RNPQ-FI. Internal consistency was assessed with Cronbach's alpha and test-retest reliability using Intraclass correlation coefficient (ICC3,1). RESULTS Cronbach's alpha was 0.44 and ICC was 0.70 (p < .001). The mean percentage of correct responses was 61.4% for physiotherapists and 62.1% for students. Forty-seven percent of the physiotherapists and 35.1% of the students reported difficulties in understanding the items. A higher amount of pain education was associated with higher RNPQ-FI scores. CONCLUSIONS The RNPQ-FI showed low internal consistency and moderate test-retest reliability among Finnish physiotherapists and physiotherapy students. Physiotherapists and students had equal amount of pain neurophysiology knowledge. Pain education is encouraged.
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Affiliation(s)
- Jolanda Ehrström
- Doctoral Programme in Clinical Research, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Reino Pöyhiä
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jyrki Kettunen
- Department of Health and Welfare, Arcada University of Applied Sciences, Helsinki, Finland
| | - Eeva Pyörälä
- Centre for University Teaching and Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
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Muller RD, Cooper J, Gliedt JA, Pohlman KA. Attitudes, beliefs, and recommendations for persistent low back pain patients: cross-sectional surveys of students and faculty at a chiropractic college. Chiropr Man Therap 2024; 32:7. [PMID: 38424615 PMCID: PMC10905815 DOI: 10.1186/s12998-024-00530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND While the use of chiropractic care for persistent low back pain (PLBP) is prevalent, chiropractors' attitudes and beliefs related to PLBP patients are not fully understood. The purpose of this study was to assess the attitudes, beliefs and activity/work recommendations of students and faculty at a chiropractic college regarding PLBP patients. METHODS The Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) and clinical vignettes were requested to be completed by chiropractic students and faculty at Parker University in April 2018. Higher HC-PAIRS scores indicate stronger beliefs that PLBP justifies disability and limitation of activities. Activity and work recommendations from clinical vignettes were rated as "adequate", "neutral", or "inadequate", as defined in previous literature. Descriptive statistics, independent t-tests, and logistic regression were used to analyze results. RESULTS Student and faculty response rates were 63.6% and 25.9%, respectively. Faculty mean HC-PAIRS scores (3.66 [SD:0.88]) were significantly lower than students' (4.41 [SD:0.71]). The percentage of faculty providing "adequate" activity (62.1%) and work (41.0%) recommendations was significantly greater than the percentage of students (activity: 33.9%, work: 21.2%) (p < 0.05). Higher HC-PAIRS scores in students were associated with decreased odds of providing "adequate" activity and work recommendations. CONCLUSIONS Student and faculty attitudes and beliefs, and students' activity/work recommendations were found to be dissimilar to those from similar studies and less congruent with CPG recommendations. Lower HC-PAIRS scores increased the odds of students providing "adequate" activity and work recommendations to patients with PLBP. Results from this study may help guide future research and training opportunities.
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Affiliation(s)
- Ryan D Muller
- VA Connecticut Healthcare System, West Haven, CT, USA
- Research Center, Parker University , Dallas, TX, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Jesse Cooper
- Baylor Scott & White Health, Round Rock, TX, USA
| | - Jordan A Gliedt
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
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Pate JW, Ilhan E, Rush GQ, Kennedy DS, Verhagen A, Pacey V, Stubbs PW. Assessing the Reconceptualization of Pain in Graduate-Entry Physiotherapy Students Using the Concept of Pain Inventory for Adults: The University of Technology Sydney Physiotherapy Student Surveys Project. JOURNAL, PHYSICAL THERAPY EDUCATION 2023; 37:302-307. [PMID: 38478785 DOI: 10.1097/jte.0000000000000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/19/2023] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Validly and reliably assessing conceptual change is essential for evaluating the effectiveness of pain science education for physiotherapy students. We aimed to 1) evaluate concept of pain before and after a 14-week pain science education university subject, 2) assess structural validity of the Concept of Pain Inventory for Adults (COPI-Adult) in postgraduate entry-level physiotherapy students, and 3) explore possible relationships between baseline variables and baseline COPI-Adult scores. REVIEW OF LITERATURE As the COPI-Adult is a newly developed questionnaire, there is a lack of data regarding its psychometric properties. SUBJECTS Of 129 enrolled students at an Australian university, 124 (96%) and 114 (88%) completed the baseline and follow-up questionnaires, respectively. METHODS In this prospective cohort study, students who commenced the degree in 2020 or 2021 completed online questionnaires, including the COPI-Adult, at the start and end of their first semester. This semester included a 14-week pain science education subject and other physiotherapy-related subjects. Higher COPI-Adult scores (range = 0-52) indicate better alignment with contemporary pain science. We 1) compared differences in concept of pain before and after the semester, 2) performed a confirmatory factor analysis on the COPI-Adult, and 3) performed exploratory regression analyses. RESULTS Concept of Pain Inventory for Adults scores increased from baseline (median [interquartile range]: 39 [36-44]) to follow-up (48 [44-51]). The COPI-Adult retained its 1-factor structure, with acceptable internal consistency (Cronbach's alpha = 0.80). Exploratory analysis showed that previously completing a subject on pain was related to higher COPI-Adult baseline scores. Age, gender, and mental health diagnosis did not relate to baseline COPI-Adult scores. DISCUSSION AND CONCLUSION Following a 14-week pain science education subject embedded within a physiotherapy degree, students improved their concept of pain. The COPI-Adult maintains a 1-factor structure in this population. Completing a previous subject on pain was associated with higher COPI-Adult scores.
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Affiliation(s)
- Joshua W Pate
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Emre Ilhan
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Gillian Q Rush
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - David S Kennedy
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Arianne Verhagen
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Verity Pacey
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Peter W Stubbs
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
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Bassimtabar A, Alfuth M. [Development and validation of a questionnaire to assess physiotherapists' postural-structural-biomechanical-oriented beliefs about pain]. Schmerz 2023:10.1007/s00482-023-00757-y. [PMID: 37845560 DOI: 10.1007/s00482-023-00757-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Therapists frequently use the postural-structural-biomechanical (PSB) model in clinical practice to explain the symptom of pain using biomechanical deficits. Adequate knowledge about pain encompasses not only the neurophysiology of pain but also knowledge that existing PSB-oriented explanations of the development and enhancement of pain are outdated. There is no assessment to evaluate physiotherapists' PSB-oriented beliefs about pain. AIM The aim of the present study was to develop a questionnaire to assess physiotherapists' PSB-oriented beliefs about pain and to evaluate its reliability (internal consistency), validity, and agreement. METHODS The Essential Knowledge of Pain Questionnaire (EKPQ) was constructed on the basis of a literature search and discussions between experts. In a pilot study, 32 pupils of a physiotherapy school were then asked to complete the German version of the revised Neurophysiology of Pain Questionnaire (rNPQ-D) and the EKPQ using the SoSci Survey in order to assess their knowledge and beliefs about pain. RESULTS The internal consistency of the EKPQ was acceptable with a Cronbach's α = 0.784. There was a strong positive significant correlation between the questionnaires (r = 0.518; p = 0.002). The Bland-Altman analysis revealed a mean difference of 28.9% (± standard deviation of the difference 15.3%) with an upper limit of 95% agreement of 58.8% and a lower limit of 95% agreement of -1.0% between the questionnaires. Participants achieved a mean score of 60.7% in the rNPQ‑D and a mean score of 31.8% in the EKPQ. CONCLUSION The newly developed EKPQ questionnaire seems to be a reliable and valid assessment to determine physiotherapists' PSB-oriented beliefs about pain. The results also confirm that a high level of knowledge about the neurophysiology of pain does not exclude a PSB orientation. Whether the EKPQ can be used alongside the rNPQ as an additional assessment to evaluate beliefs about pain should be investigated in the future with suitable study designs, e.g. Delphi study.
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Affiliation(s)
- Ahura Bassimtabar
- Fachbereich Gesundheitswesen, Hochschule Niederrhein, Reinarzstr. 49, 47805, Krefeld, Deutschland
- Universitäre Weiterbildung M.Sc. Sportphysiotherapie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland
- Bayer 04 Leverkusen Fußball GmbH, Bismarckstr. 122-124, 51373, Leverkusen, Deutschland
| | - Martin Alfuth
- Fachbereich Gesundheitswesen, Hochschule Niederrhein, Reinarzstr. 49, 47805, Krefeld, Deutschland.
- Universitäre Weiterbildung M.Sc. Sportphysiotherapie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland.
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Mankelow J, Ravindran D, Graham A, Suri S, Pate JW, Ryan CG, Martin D. An evaluation of a one-day pain science education event in a high school setting targeting pain related beliefs, knowledge, and behavioural intentions. Musculoskelet Sci Pract 2023; 66:102818. [PMID: 37418949 DOI: 10.1016/j.msksp.2023.102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Persistent pain is a common condition affecting one in four UK adults. Public understanding of pain is limited. Delivering pain education within schools may improve public understanding in the longer term. OBJECTIVE To evaluate the impact of a one-day Pain Science Education (PSE) event on sixth form/high school students' pain beliefs, knowledge and behavioural intention. METHODS Exploratory, single-site, mixed-methods, single-arm study involving secondary school students ≥16 years old attending a one-day PSE event. Outcome measures included the Pain Beliefs Questionnaire (PBQ), Concepts of Pain Inventory (COPI-ADULT), a vignette to assess pain behaviours; and thematic analysis of semi-structured interviews. RESULTS Ninety (mean age 16.5 years, 74% female) of the 114 attendees, agreed to participate in the evaluation. PBQ scores improved on the Organic beliefs subscale [mean difference -5.9 (95% CI -6.8, -5.0), P < 0.01] and Psychosocial Beliefs subscale [1.6 (1.0, 2.2) P < 0.01]. The COPI-Adult revealed an improvement [7.1 (6.0-8.1) points, P < 0.01] between baseline and post intervention. Pain behavioural intentions improved post education for work, exercise, and bed rest related activities (p < 0.05). Thematic analysis of interviews (n = 3) identified increased awareness of chronic pain and its underpinning biology, beliefs that pain education should be widely available, and that pain management should be holistic. CONCLUSIONS A one-day PSE public health event can improve pain beliefs, knowledge and behavioural intentions in high school students and increase openness to holistic management. Future controlled studies are needed to confirm these results and investigate potential long-term impacts.
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Affiliation(s)
- J Mankelow
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK.
| | - D Ravindran
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Royal Berkshire NHS Foundation Trust, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - A Graham
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - S Suri
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; NIHR Applied Research Collaboration for the North East and North Cumbria, Newcastle Upon Tyne, England, UK
| | - J W Pate
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - C G Ryan
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - D Martin
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; NIHR Applied Research Collaboration for the North East and North Cumbria, Newcastle Upon Tyne, England, UK; Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Helms J, Frankart L, Bradner M, Ebersole J, Regan B, Crouch T. Interprofessional Active Learning for Chronic Pain: Transforming Student Learning From Recall to Application. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231221950. [PMID: 38152832 PMCID: PMC10752086 DOI: 10.1177/23821205231221950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
Chronic pain (CP) affects over 50 million Americans daily and represents a unique challenge for healthcare professionals due to its complexity. Across all health professions, only a small percentage of the curriculum is devoted to treating patients with CP. Unfortunately, much of the content is delivered passively via lecture without giving students an opportunity to practice the communication skills to effectively treat patients in the clinic. An interprofessional team of health educators identified 5 essential messages that students frequently struggle to convey to patients with CP. Those messages were based on interprofessional and profession-specific competencies to treat patients with CP from the International Association for the Study of Pain. The 5 messages highlighted the importance of (1) therapeutic alliance, (2) consistent interdisciplinary language, (3) patient prognosis, (4) evidence for pain medicine, surgery, and imaging, and (5) early referral to the interprofessional team. For each message, the team summarized relevant research supporting the importance of each individual message that could serve as a foundation for didactic content. The team then developed active learning educational activities that educators could use to have students practice the skills tied to each message. Each learning activity was designed to be delivered in an interprofessional manner.
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Affiliation(s)
- Jeb Helms
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, USA
| | - Laura Frankart
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Melissa Bradner
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, USA
| | | | - Beck Regan
- Virginia Commonwealth University, Richmond, USA
| | - Taylor Crouch
- Virginia Commonwealth University Health System, Richmond, USA
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Mankelow J, Ryan CG, Taylor PC, Casey MB, Naisby J, Thompson K, McVeigh JG, Seenan C, Cooper K, Hendrick P, Brown D, Gibson W, Travers M, Kennedy N, O'Riordan C, Martin D. International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students. BMC MEDICAL EDUCATION 2022; 22:547. [PMID: 35840942 PMCID: PMC9284700 DOI: 10.1186/s12909-022-03488-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Persistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students' pain related knowledge and attitudes. The secondary aim was to explore what factors influence students' pain related knowledge and attitudes. METHODS In this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes]. RESULTS Physiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01) and attitudes (-17.2, -19.2 to 15.2, p = 0.01) between first and final year. Pain education teaching varied considerably from course to course (0 to 40 h), with greater levels of pain related knowledge and attitudes associated with higher volumes of pain specific teaching. CONCLUSIONS There was little difference in pain knowledge and attitudes between all first and final year NMAHP students other than physiotherapy. This suggests that for most NMAHP disciplines, undergraduate teaching has little or no impact on students' understanding of pain. There is an urgent need to enhance pain education provision at the undergraduate level in NMAHPs. TRIAL REGISTRATION The study protocol was prospectively registered at ClinicalTrials.Gov NCT03522857 .
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Affiliation(s)
- Jagjit Mankelow
- Teesside University, Middlesbrough, England.
- University of Limerick, Limerick, Ireland.
| | | | | | | | | | | | | | - Chris Seenan
- Glasgow Caledonian University, Glasgow, Scotland
| | - Kay Cooper
- Robert Gordon University, Aberdeen, Scotland
| | | | - Donna Brown
- University of Ulster, Belfast, Northern Ireland
| | - William Gibson
- The University of Notre Dame Australia, Fremantle, Australia
| | - Mervyn Travers
- The University of Notre Dame Australia, Fremantle, Australia
- Curtin University, Perth, Australia
| | | | | | - Denis Martin
- Teesside University, Middlesbrough, England
- Applied Research Collaboration for the North East and North Cumbria, National Institute for Health and Care Research, Newcastle Upon Tyne, England
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Mankelow J, Ryan CG, Green PW, Taylor PC, Martin D. An exploration of primary care healthcare professionals' understanding of pain and pain management following a brief pain science education. BMC MEDICAL EDUCATION 2022; 22:211. [PMID: 35351106 PMCID: PMC8962069 DOI: 10.1186/s12909-022-03265-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Persistent pain is a leading cause of disability worldwide yet implementation of clinical guidelines that recommend a biopsychosocial approach remains a challenge in clinical practise. Limited pain understanding amongst clinicians may be partly responsible for this. PURPOSE OF THE STUDY 1) Qualitatively explore the experience of receiving PSE, understanding of PSE and operationalisation of PSE-related principles in routine clinical practice. 2) Quantitatively explore pain knowledge, attitudes, and behaviours of general practitioners (GPs) and nurse practitioners (NPs) before and after pain science education (PSE). METHODS An exploratory, single-site, mixed-methods study in north-east England. Fifteen NPs/GPs completed questionnaires and a case-vignette before and after a 70-min face-to-face PSE lecture. Qualitative data were thematically analysed from two focus groups after the intervention. RESULTS Clinicians' relatively high prior levels of knowledge, attitudes, and behaviour were similar after PSE. Qualitative themes described facilitation of self-reflection on pain management behaviours, and difficulties in operationalising PSE principles in practise including: limited patient rapport; short appointment times; patients' passive and often oppositional biomedical treatment expectations; and clinicians' lack of readily understandable language to communicate with patients. CONCLUSION The findings highlight the value of PSE perceived by these clinicians who were already favourably inclined towards biopsychosocial pain management. They sought more resources for their personal learning and for communication with patients. Even with such favourable disposition, the practicalities and environment of clinical practice impeded the operationalisation of PSE-related principles. TRIAL REGISTRATION This study was prospectively registered at ClinicalTrials.Gov ( NCT04587596 ) in October 2020.
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Affiliation(s)
- Jagjit Mankelow
- School of Health and Life Sciences, Centuria Building, Teesside University, Middlesbrough, Tees Valley TS1 3BX England
| | - Cormac G. Ryan
- School of Health and Life Sciences, Centuria Building, Teesside University, Middlesbrough, Tees Valley TS1 3BX England
| | - Paul W. Green
- Linthorpe Surgery, 378 Linthorpe Road, Middlesbrough, TS5 6HA England
| | - Paul C. Taylor
- School of Social Sciences, Humanities and Law Education and Social Work, Teesside University Middlesbrough, Middlesbrough, Tees Valley TS1 3BX England
| | - Denis Martin
- NIHR Applied Research Collaboration for the North East and North Cumbria, Newcastle Upon Tyne, England
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Fitzgerald K, Vaughan B, Devonshire E, Schneider C, Denham R. No gain without pain education: Improving knowledge and biopsychosocial attitudes and beliefs in a predominantly non-health-related undergraduate target audience. Musculoskeletal Care 2022; 20:660-665. [PMID: 35278023 DOI: 10.1002/msc.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Chronic pain (CP) impacts individuals and society and is the leading cause of disability globally. Pain education interventions are often evaluated in patients and health professional students, but not in non-health student groups. Increasing knowledge of pain may facilitate shifts in attitudes and beliefs towards sufferers. We report on changes in pain knowledge, attitudes and beliefs of predominantly non-health-related tertiary degree students participating in online education. METHODS Quantitative cohort study design. Students reported demographics and completed the Chronic Pain Myth Scale and 12-item Neurophysiology of Pain Questionnaire (NPQ) before (T1) and after (T2) the 7-week online module at The University of Sydney in 2020. RESULTS Twenty-two students undertaking predominantly non-health-related bachelor's degrees (16.5% response rate, 90.9% female, mean = 19.5 years) participated. NPQ scores increased from 47.3% to 62.9%. Attitudes and beliefs towards biopsychosocial impact improved (p < 0.027) but not towards individuals suffering from CP or treatment of CP. A negative correlation was found between age and people suffering from CP (ρ = -0.437, p < 0.042) and age and towards treatment of CP; ρ = -0.556, p < 0.007) at T2. CONCLUSION Completing the elective online module resulted in improved knowledge and biopsychosocial attitudes towards CP in this predominantly non-health cohort, as reported in health and patient cohorts.
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Affiliation(s)
- Kylie Fitzgerald
- Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Brett Vaughan
- Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth Devonshire
- Pain Education Unit, Sydney Medical School - Northern, The University of Sydney, Sydney, New South Wales, Australia
| | - Carl Schneider
- School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Denham
- Educational Innovation, The University of Sydney, Sydney, New South Wales, Australia
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Gül H, Erel S, Demir P, Çubukçu Fırat S. Cross-cultural adaptation of the Revised Neurophysiology of Pain Questionnaire into the Turkish language based on Rasch analysis. Physiother Theory Pract 2022:1-9. [PMID: 35260038 DOI: 10.1080/09593985.2022.2048425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Revised Neurophysiology of Pain Questionnaire (Revised-NPQ-Tr) is used to evaluate the chain in pain knowledge. No study has explored its validity and reliability for the Turkish language. OBJECTIVES : This study aims to determine the psychometric properties of the Turkish version of the Revised-NPQ-Tr in chronic spinal pain patients. METHODS A total of 182 chronic spinal pain patients were included in the study. The Revised-NPQ-Tr results were analyzed using Rasch analysis to measure the psychometric properties. RESULTS The Revised-NPQ-Tr indicates misfit to the Rasch model, as evidenced by the borderline significant p value (LR test = 27.626; df = 11; p = .004; Bonferroni-adjusted α = 0.004). Two items were differentially affected by educational status. Removal of poor-functioning items did not improve the psychometric properties of the questionnaire. The Revised-NPQ-Tr is unidimensional and there was no local dependence between items. The questionnaire exhibits known group validity. Test-retest reliability of the questionnaire was moderate [intraclass correlation coefficient (ICC) = 0.629]; however, the internal consistency of the questionnaire was found to be low (Cronbach's α = 0.330; person separation index = 0.373). CONCLUSION Although the internal validity of the Revised-NPQ-Tr version was acceptable, its reliability was found to be low. Consequently, the results of Revised-NPQ-Tr should be interpreted carefully in the clinic.
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Affiliation(s)
- Hatice Gül
- Vocational School of Health Services, Akdeniz University, Antalya, Turkey
| | - Suat Erel
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Pervin Demir
- Department of Biostatistics and Medical Informatics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Sibel Çubukçu Fırat
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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11
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Ehrström J, Pöyhiä R, Kettunen J, Santavirta N, Pyörälä E. Psychometric properties and factor structure of the Finnish version of the Health Care Providers' Pain and Impairment Relationship Scale. Musculoskelet Sci Pract 2022; 57:102471. [PMID: 34740150 DOI: 10.1016/j.msksp.2021.102471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/25/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Health care providers' beliefs influence the outcomes of low back pain patients care. OBJECTIVES The aim of this study was to translate and cross-culturally adapt the Health Care Providers' Pain and Impairment Relationship Scale into Finnish (HC-PAIRS-FI) and to evaluate its psychometric properties and factor structure in a sample of Finnish physiotherapists and physiotherapy students. METHODS The translation was performed using established guidelines. Participants answered an online survey consisting of HC-PAIRS-FI and the Finnish Tampa Scale of Kinesiophobia adapted for health care providers (TSK-HC-FI). Internal consistency was assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability. A second round of analysis, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed as the fit indices of the initial CFA were not satisfactory. RESULTS A sample of 202 physiotherapists and 97 physiotherapy students completed the survey. The second round of analysis EFA and CFA, conducted on a randomly split subsample, revealed and confirmed a three-factor, 11-item HC-PAIRS-FI scale with satisfactory model fit indices. Cronbach's alpha 0.79 and ICC = 0.82 (p < 0.001) indicate good internal consistency and test-retest reliability. The standard error of measurement was 2.12. HC-PAIRS-FI scores correlated moderately with TSK-HC-FI (r = 0.69, p < 0.001). CONCLUSIONS The 11 items HC-PAIRS-FI appears to be a valid and reliable questionnaire to evaluate Finnish physiotherapists' and physiotherapy students' attitudes and beliefs about the relationship between chronic low back pain and impairment. Future studies are required to validate this scale for other health care providers.
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Affiliation(s)
- Jolanda Ehrström
- University of Helsinki, Doctoral Programme in Clinical Research, Faculty of Medicine, P.O. Box 63, 00014, University of Helsinki, Helsinki, Finland.
| | - Reino Pöyhiä
- University of Eastern Finland, Institute of Clinical Medicine, Department of Anaesthesia, P.O. Box 100, 70029, Kuopio University Hospital, Kuopio, Finland
| | - Jyrki Kettunen
- Arcada University of Applied Sciences, Department of Health and Welfare, Jan-Magnus Janssonin Aukio 1, 00550, Helsinki, Finland
| | - Nina Santavirta
- University of Helsinki, Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland
| | - Eeva Pyörälä
- University of Helsinki, Centre for University Teaching and Learning, Faculty of Educational Sciences, University of Helsinki, P.O. Box 21, 00014, Finland
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12
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Mikamo Y, Takasaki H. Pain Neurophysiology Knowledge Enhances Attitudes toward Biopsychosocial Management of Low Back Pain among Japanese Physical Therapists. Prog Rehabil Med 2021; 6:20210039. [PMID: 34712862 PMCID: PMC8511003 DOI: 10.2490/prm.20210039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of the current study was to investigate whether a postgraduate academic degree, longer clinical experience, and pain neurophysiology knowledge influence attitudes toward the balance between biomedical and biopsychosocial management of low back pain (LBP). Methods: Ninety Japanese physical therapists completed the revised Neurophysiology of Pain Questionnaire (revised NPQ), the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) questionnaire, and a survey on their degree qualifications and clinical experience. Their attitudes toward the balance between biomedical and biopsychosocial management of LBP were assessed using the mean biomedical scale scores divided by the mean biopsychosocial scale scores of the PABS-PT. Multiple regression modeling of the attitudes toward the balance between biomedical and biopsychosocial management of LBP was carried out using three independent variables: possession of an undergraduate or postgraduate academic degree, length of clinical experience, and the score on the revised NPQ. Results: Of the 90 therapists, 72 had an undergraduate degree and 18 also had a postgraduate degree. Only the revised NPQ score (β=−0.364, P <0.001) was a statistically significant contributing factor to attitudes toward the balance between biomedical and biopsychosocial management of LBP (R2=0.14). Neither having a postgraduate degree (β=0.017, P=0.871) nor the length of clinical experience (β=−0.107, P=0.303) had a significant effect. Conclusions: This study demonstrated that pain neurophysiology knowledge, but not the possession of a postgraduate academic degree or the length of clinical experience, promotes attitudes toward biopsychosocial management of LBP among Japanese physical therapists.
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Affiliation(s)
- Yuri Mikamo
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
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Mankelow J, Ryan CG, Morris H, Lauchlan D, Seenan C, Taylor P, Martin D. Charting physiotherapy students' attitudes toward people with chronic pain as they progress through their undergraduate programme: An observational study. Physiother Theory Pract 2021; 38:2658-2664. [PMID: 34496724 DOI: 10.1080/09593985.2021.1976890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Healthcare professionals' attitudes toward people with chronic pain influence their clinical practice. OBJECTIVES To investigate physiotherapy students' attitudes and beliefs toward people with chronic pain over the course of their Scottish undergraduate program. METHODS In this observational study, physiotherapy students from one university were recruited in the first year and followed up to their final year (year 1 n = 62/75, year 2 n = 68/72, year 3 n = 59/69, year 4 n = 74/74) for 4 years. The Health-Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS with scores ranging from 15 to 105) was completed annually. RESULTS A one-way ANOVA found that attitudes and beliefs improved significantly (p < .01) from the first to final year (9.2 ± 11.5 (mean±SD)). Participants showed a reduction in scores (signifying improved attitudes) annually with smaller reductions initially followed by a larger reduction in the final 2 years. CONCLUSIONS This is the first study to chart changes in the same cohort of physiotherapy students' attitudes and beliefs toward people with chronic pain over time. Future work should explore which aspects of degree courses, if any, impact upon attitudes and beliefs toward people with chronic pain so that courses can be enhanced accordingly.
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Affiliation(s)
- Jagjit Mankelow
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Cormac G Ryan
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Hayley Morris
- Institute of Cancer Sciences, University of Glasgow, Bearsden, Scotland
| | - Douglas Lauchlan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Christopher Seenan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Paul Taylor
- School of Health and Social Care, Centuria Building,Teesside University, UK
| | - Denis Martin
- School of Health and Social Care, Centuria Building,Teesside University, UK
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