Der Einsatz eines psychosozialen Screenings von Physiotherapeut*innen in Österreich

Zusammenfassung

Gelbe Flaggen (Yellow Flags) tragen zur Entwicklung chronischer Schmerzen bei. Deren Bewertung mit Hilfe von Screening-Instrumenten wird in den höchsten Qualitätsleitlinien empfohlen. Wie sich jedoch herausstellte, erheben viele Physiotherapeut*innen (PTs) diese nicht. Ziel dieser Arbeit war es, herauszufinden, welche Yellow Flags und welche entsprechenden Fragebögen für muskuloskelettal assoziierte Schmerzen von PTs in Österreich regelmäßig erhoben bzw. verwendet werden.

Eine selbst gestaltete Online-Umfrage mit Single-Choice-, Multiple-Choice- und offenen Fragen wurde über den Verteiler von Physio Austria und über Verteiler von Fachhochschulen verschickt. Nur PTs, die im muskuloskelettalen Bereich tätig sind, unabhängig vom spezifischen Arbeitssetting, wurden in diese Umfrage einbezogen.

Am Ende des Durchführungszeitraums nahmen 127 PTs an der Umfrage teil. Es ergaben sich dabei folgende Ergebnisse: (1) Die wichtigsten Yellow Flags, die zur Chronifizierung von muskuloskelettalen Schmerzen beitragen (Depressivität, anhaltender Stress, passive Bewältigungsstrategien, angstorientiertes Verhalten) werden von 75–91% der PTs (n=127) oft bis immer angegeben; (2) 50% der befragten PTs kennen keinen der genannten unidimensionalen Fragebögen (TSK etc.) und 51% kennen keinen der multidimensionalen Fragebögen (OMSQ etc.). PTs, die die entsprechenden Screening-Instrumente kennen, verwenden diese nur in sehr geringem Ausmaß oft bis immer.

Diese Untersuchung zeigt, dass einzelne Yellow Flags von den befragten PTs regelmäßig erhoben werden, aber nur 39% ein gezieltes Screening von Yellow Flags anwenden, obwohl sich immerhin 94% der Befragten für deren Erhebung verantwortlich fühlen.

Aufgrund der reduzierten Differenzierungsfähigkeit zwischen den einzelnen Flaggen bei muskuloskelettalen Schmerzen sollte für das Screening von Yellow Flags ein Screening-Tool eingesetzt werden. Damit die Durchführung eines standardisierten, von Leitlinien empfohlenen Screenings in Zukunft möglich wird, müssen PTs die entsprechenden multi- und unidimensionalen Fragebögen kennenlernen und die Fähigkeit erwerben, diese richtig einzusetzen.

Abstract

Yellow flags contribute to the development of chronic pain. Their assessment using screening tools is recommended in the highest quality guidelines. However, it turned out that many physiotherapists (PTs) do not collect these. The aim of this study was to find out which yellow flags and which corresponding questionnaires for musculoskeletal-associated pain are regularly used by PTs in Austria.

A self-designed online survey with single-choice, multiple-choice and open questions was sent via the Physio Austria mailing list and the mailing lists of universities of applied sciences. Only PTs working in the musculoskeletal field, regardless of the specific work setting, were included in this survey.

At the end of the implementation period, 127 PTs took part in the survey. The following results were obtained: (1) The most important yellow flags that contribute to the chronification of musculoskeletal pain (depression, persistent stress, passive coping strategies, anxiety-oriented behaviour) are often to always indicated by 75-91% of the PTs surveyed (n=127); (2) 50% of the PTs do not know any of the unidimensional questionnaires mentioned (TSK etc.) and 51% do not know any of the multidimensional questionnaires (OMSQ etc.). PTs familiar with the relevant screening instruments only use them to a minimal extent, often to always.

This study shows that individual yellow flags are regularly recorded by the PTs surveyed, but only 39% use targeted screening of yellow flags, although 94% of respondents feel responsible for recording them.

Due to the reduced ability to differentiate between the individual flags in musculoskeletal pain, a screening tool should be used to screen for yellow flags. In order for standardised screening recommended by guidelines to be possible in the future, PTs must become familiar with the relevant multi- and unidimensional questionnaires and acquire the ability to use them correctly.

Schlüsselwörter

Screening - psychosozial - Yellow Flags - Risikofaktoren - Physiotherapie

Key words

screening - psychosocial - yellow flags - risk factors - physiotherapy

Publication History

Received: 17 October 2023

Accepted: 14 January 2024

Article published online:
17 February 2025

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