Page 130 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij
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Chapter 7
  Box 1
   IP-dimension Threshold
IP1 Consequences 8
IP2 Timeline 8
IP3 Personal Control 7
IP4 Treatment Control 4
          IP-dimension Threshold
IP5 Identity 8
IP6 Concern 8
IP7 Coherence 5
IP8 Emotional Response 8
    Exclusion criteria were specific LBP and existing (and diagnosed) psychiatric illness. When matching the inclusion criteria, patients were invited to participate by their physiotherapist after reading the patient information letter. Their decision on participating in the study did not have consequences for their treatment. After signing the informed consent, patients were included in the study.
Matched-care treatment package
We used the Dutch guideline for LBP, and added a treatment package which was based on three frequently applied strategies for persistent LBP19 (Appendix B). The specific aim of this response guided treatment package was to alter the dysfunctional levels of IPs by using cognitive, exposure and/or respondent strategies19. For instance, a cognitive strategy showed successful improvements in patient- relevant physical activities in patients with more than one year LBP35. Participating physiotherapists were asked to record the number of times each treatment strategy was applied during treatment phase B.
The treatment package offered the patient and physiotherapist the possibility to create a matched-care intervention as advised in the Dutch Guideline for Low Back Pain. This means that patients’ ‘risk-profile’ scores were assessed before each intervention and consequent- ly these scores were used to design the response guided treatment, thereby providing matched-care (see paragraph 2.4).
Measures
An online questionnaire was developed for assessing primary outcomes (pain intensity, physical function, and pain interference), secondary outcome (Illness Perceptions) and the co-variates (fear for damage/pain, pain anxiety, depressive mood, avoidance beliefs and sleep). Frequent administration allowed for monitoring the effect of the treatment package on all outcomes. These items are described below.
Primary outcome
Three outcome measures were chosen as primary outcome based on consensus recommendations from the literature; 1) pain intensity in the last 24-hours1. 2) limitation in patients’ own selected physical function and 3) pain interference in daily activities12.
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