Abstract :
[en] Introduction : Chronic pain is a major public health issue that osteopaths often face in consultation. Chronic pain is complex to manage as it requires osteopaths to help patients to engage in self-management while integrating their biopsychosocial (BPS) factors. The literature highlights a lack of training of osteopaths in this field. In order to promote self management and support patient learning, several organizations recommend the use of patient education tools and materials that take into account the level of Health Literacy (HL) of patients. At our knowledge, such materials does not exist in the osteopathic literature. This pilot study aims to design and evaluate an educational tool for patients suffering from chronic pain.
Method : The protocol was built in several steps for the design and evaluation of the tool. Firstly, a needs evaluation phase was carried out among 4th (n=32) and 5th year students (n=18) and the supervisors (n=8) of the CEESO Paris clinic in order to know their expectations regarding such a tool. The second phase was design of the the tool including literature about chronic pain, BPS model and HL. Then the tool was evaluated in a clinical setting using the evaluation criteria derived from the INPES recommendations. These criteria included content and support quality criteria, pedagogical criteria and the tool's practicability criteria. The data were analyzed by a Chi-Square test of compliance. This study was approved by the CEESO Paris ethics committee.
Results : The tool was tested by 10 5th year students and meets most of the criteria of the grid (n=10). All the general criteria were reported as very satisfactory (p<0.011), as were the criteria of quality of support, content (p<0.011) and practicability (p<0.011), with the exception of the items : « adaptability to the disability situation » and « sustainability ». For the educational criterion, the results were mostly satisfactory (5 items out of 12), 3 items were very satisfactory (p<0.001): « the tool allows the memorization of knowledge », « enhances the patient's participation » and « allows the patient to become aware of his attitude ». Nevertheless, 4 items were not significant although the respondents tended to answer that the tool is satisfactory or even very satisfactory: « to reproduce gestures », « to take into account the patient's experience », «to facilitate the integration of knowledge » and « to support the change of habits ».
Discussion : The results show that the tool can help students to be more patient-centered and to establish a diagnosis of biopsychosocial factors. From the literature, the tool seems to contribute to patient self-management by formulating educational objectives with the patient and providing information. However, according to our results, the students were less comfortable using the educational potential of the tool while applying these objectives in the patient's daily life and changing their habits. This highlights the need to train students in educational skills in order to maximize the effectiveness of this tool. Further studies are needed in order to test this tool in a larger scale, question its usefulness for pluridisplinary care and integrate patient feedback.
