198: Physical Activity Prescribing By Community Paediatricians for Children with Chronic Pain: A Vignette Based Study
Notice bibliographique
Résumé
Regular physical activity (PA) promotes optimum health and development. Youth with chronic pain are less physically active than healthy peers. Recommendation by a health care provider is a key factor influencing the decision to initiate a regular program. The Canadian Paediatric Society provides general fitness guidelines and some disease-specific recommendations. Little is known about PA prescribing behaviors of paediatricians working with children and youth with chronic pain. Describe PA prescribing behaviors of paediatricians for children and youth with chronic pain. Examine patient/provider characteristics that influence PA prescribing. Ethics approval was obtained. The survey was developed on FluidSurveys. A survey link was distributed to 360 paediatricians on the Canadian Paediatric Society Community Paediatrics listserv. Ten vignettes varied on eight factors (age, sex, income level, pain intensity, pain frequency, pain duration, location and current physical activity participation). No vignette patient achieved recommended PA levels and all were safe to increase PA. Analysis included descriptive analysis and Generalized Estimating Equations with confidence as the dependent. Eighteen paediatricians participated, providing 122 completed vignette responses; 67% of participants were female, 50% of participants indicated they were regularly active, 78% worked in a unidisciplinary setting. The mean duration of practice was 17 years. Paediatricians recommended the following activity for vignette patients with chronic pain: restrict or reduce PA (2.5%), continue current level (13.1%), general activity increase recommendations (26.2%), specific advice to increase (27%), refer to other provider for advice on increasing level (31.1%). Paediatricians (n=121) had the following level of confidence in their recommendations: 2.5% were not at all confident, 38.8% were not so confident, 47.1% were confident and 11.6% were highly confident. Paediatricians (n=119) had the following level of confidence that their recommendations would be followed: 9.8% were not at all confident, 41% were not so confident, 34.4% were confident and 12.3% were highly confident. Factors significantly associated with confidence in PA prescribing included regular physician PA practices (P=0.035), multi-disciplinary setting (P=0.014) and fewer years of practice (P=0.024). Most participants' recommended increased PA. Higher physician activity level, multidisciplinary practice and fewer years in practice were associated with increased confidence in recommendations. Development of supports such as educational material or clinical decision tools for PA prescribing for children and youth with chronic pain may benefit community paediatricians and their patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».