¿Influyen las expectativas de los pacientes en el tratamiento conservador de la lumbalgia crónica? Una revisión narrativa (Do patients’ expectations influence conservative treatment in Chronic Low Back Pain? A Narrative Review)

Autores/as

  • Enrico Ballestra Università degli Studi del Piemonte Orientale, Novara, Italy
  • Andrea Battaglino IRCCS Fondazione Don Carlo Gnocchi
  • Diego Cotella Università degli Studi del Piemonte Orientale, Novara, Italy
  • Giacomo Rossettini School of Physiotherapy, University of Verona, Verona, Italy
  • Eleuterio A. Sanchez-Romero Universidad Europea de Madrid, Spain
  • Jorge Hugo Villafane Fondazione Don Carlo Gnocchi Onlus

DOI:

https://doi.org/10.47197/retos.v46.93950

Palabras clave:

Low Back Pain, Chronic Pain, Expectations

Resumen

Introducción: El manejo clínico del dolor lumbar crónico (DLC) varía sustancialmente entre médicos generales, especialistas y fisioterapeutas pertenecientes a un mismo país, lo que da lugar a un amplio espectro de enfoques. Objetivo: Determinar cómo las expectativas de resultados influyen en el tratamiento conservador de los pacientes en edad laboral con DLC. Métodos: Se presenta  una revisión narrativa de los estudios que investigan o informan de una asociación entre las expectativas de los pacientes y el tratamiento conservador en pacientes con DCL en edad laboral. Se siguieron las directrices de la revisión narrativa durante el diseño, la investigación y el informe. Resultados: Los artículos se seleccionaron mediante el análisis de los títulos y los resúmenes o los artículos completos. Este proceso dio como resultado un total de 5 estudios que cumplían los criterios de selección y, por lo tanto, se incluyeron en la revisión  y se consideraron elegibles para la evaluación de la calidad a través de la herramienta Critical Appraisal Skills Programme (CASP) y la escala PEDro (Physiotherapy Evidence Database). Lo que se desprende de los estudios incluidos en la revisión se refiere esencialmente a tres temas principales: (a) las expectativas de resultados, muy influenciadas por las experiencias previas de los pacientes; (b) la expectativa del paciente relacionada con el profesional clínico que incluye el deseo de recibir información y educación sobre el trastorno y (c) las relativas al entorno o contexto. Conclusiones: Los resultados de los estudios analizados muestran que ciertas expectativas de los pacientes, como la expectativa de un tratamiento a medida con seguimientos frecuentes, la esperanza de obtener  los mejores resultados posibles, el realismo sincero  o la resignación respecto al alivio del dolor, los niveles de actividad, el buen diálogo y la comunicación, la necesidad de ser visto y confirmado como individuo y el deseo de recibir una explicación del dolor podrían estar relacionados con unos mejores resultados de recuperación.

Abstract. Introduction: The clinical management of Chronic Low Back Pain (CLBP) substantially varying among general practitioners, specialists and physical therapists belonging to the same country, resulting in a wide spectrum of approaches. Objective: To determine how outcome expectations influence conservative treatment of working-age patients with CLBP. Methods: This is a narrative review of studies investigating or reporting an association between patients’ expectation and conservative treatment in patients with CLBP in working-age. Narrative review’s guidelines were followed during the design, research, and reporting. Results: The articles were screened by reading the titles and abstracts or full articles. This process resulted in a total of 5 studies that met the selection criteria and were therefore included in the systematic review and considered eligible for quality assessment through the Critical Appraisal Skills Programme (CASP) tool and PEDro (Physiotherapy Evidence Database) scale. What emerges from the studies included in the review essentially concerned three main topics: (a) the expectations of results, highly influenced by patients’ previous experiences; (b) the expectation concerning the clinical professional which includes the desire to receive information and education about the disorder and (c) those about environment or context. Conclusions: The results of the studies analyzed show that certain patients’ expectations, such as the expectation of tailored training with frequent follow-ups, the hope for the best possible outcomes, realism or resignation regarding pain relief, activity levels, good dialogue and communication, the need to be seen and confirmed as an individual and the desire to receive an explanation for the pain could be related to a better recovery outcomes. 

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Publicado

2022-09-28

Cómo citar

Ballestra, E., Battaglino, A., Cotella, D., Rossettini, G., Sanchez-Romero, E. A., & Villafane, J. H. (2022). ¿Influyen las expectativas de los pacientes en el tratamiento conservador de la lumbalgia crónica? Una revisión narrativa (Do patients’ expectations influence conservative treatment in Chronic Low Back Pain? A Narrative Review). Retos, 46, 395–403. https://doi.org/10.47197/retos.v46.93950

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Revisiones teóricas, sistemáticas y/o metaanálisis

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