期刊论文详细信息
BMC Musculoskeletal Disorders
Low back pain beliefs are associated to age, location of work, education and pain-related disability in Chinese healthcare professionals working in China: a cross sectional survey
Andrew M Briggs1  Angus F Burnett4  Gang Chen3  Peter B O’Sullivan5  Anne J Smith5  B-K Tan2 
[1] Arthritis and Osteoporosis Victoria, PO Box 130, Caulfield South 3162 Victoria, Australia;International Health, School of Nursing and Midwifery, Curtin University, GPO Box U 1987, Perth, Western Australia 6845, Australia;School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, PR China;ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar;School of Physiotherapy & Exercise Science, Curtin University, GPO Box U 1987, Perth, Western Australia 6845, Australia
关键词: Fear avoidance;    Healthcare professionals;    China;    Back pain beliefs;    Low back pain;   
Others  :  1122294
DOI  :  10.1186/1471-2474-15-255
 received in 2014-03-11, accepted in 2014-07-17,  发布年份 2014
PDF
【 摘 要 】

Background

Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge gap among these relationships in non-western countries. The aim of this study was to examine the associations between LBP-related beliefs among Chinese HCPs and characteristics of these HCPs.

Methods

A convenience sample of 432 HCPs working in various health settings in Shanghai, China, completed a series of questionnaires assessing their demographic characteristics, LBP status, pain-related disability and their beliefs about their own LBP experience, using the Back beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ).

Results

Younger Chinese HCPs (20–29 years) held more negative beliefs and attitudes related to LBP compared to older HCPs (>40years; BBQ mean difference [95% CI]: 2.4 [0.9 - 3.9], p = 0.001). HCPs working outside tertiary hospitals had poorer beliefs concerning the inevitable consequences of LBP (BBQ mean difference [95% CI]: −2.4 [−3.8 - −1.0], p = 0.001). HCPs who experienced LBP had higher level of fear avoidance beliefs when experiencing high LBP-related disability (FABQ-physical mean difference [95% CI]: 2.8 [1.5 - 4.1], p < 0.001; FABQ-work mean difference [95% CI]: 6.2 [4.0 - 8.4], p < 0.001)) and had lower level of fear avoidance beliefs if they had completed postgraduate study (FABQ-physical mean difference [95% CI]: 2.9 [−5.8 - 0.0], p = 0.049).

Conclusion

This study suggests that LBP-related beliefs and attitudes among Chinese HCPs are influenced by age, location of work, level of LBP-related disability and education level. Understanding back pain beliefs of Chinese HCPs forms an important foundation for future studies into the condition and its management in China.

【 授权许可】

   
2014 Tan et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150213030429277.pdf 284KB PDF download
【 参考文献 】
  • [1]Deyo RA, Mirza SK, Turner JA, Martin BI: Overtreating chronic back pain: time to back off? J Am Board Fam Med 2009, 22(1):62-68.
  • [2]Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD: Expenditures and health status among adults with back and neck problems. JAMA 2008, 299(6):656-664.
  • [3]Yang G, Wang Y, Zeng Y, Gao GF, Liang X, Zhou M, Wan X, Yu S, Jiang Y, Naghavi M, Vos T, Wang H, Lopez AD, Murray CJ: Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 2013, 381(9882):1987-2015.
  • [4]Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basanez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D, et al.: Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012, 380(9859):2163-2196.
  • [5]Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basanez MG, Baxter A, Bell ML, Benjamin EJ, et al.: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012, 380(9859):2197-2223.
  • [6]Poiraudeau S, Rannou F, Le Henanff A, Coudeyre E, Rozenberg S, Huas D, Martineau C, Jolivet-Landreau I, Revel M, Ravaud P: Outcome of subacute low back pain: influence of patients’ and rheumatologists’ characteristics. Rheumatology (Oxford) 2006, 45(6):718-723.
  • [7]Rugelj D: Low back pain and other work-related musculoskeletal problems among physiotherapists. Appl Ergon 2003, 34:635-639.
  • [8]Smith D, Mihashi M, Adachi Y, Koga H, Ishitake T: A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses. J Safety Res 2006, 37(2):195-200.
  • [9]Lin PH, Tsai YA, Chen WC, Huang SF: Prevalence, characteristics, and work-related risk factors of low back pain among hospital nurses in Taiwan: a cross-sectional survey. Int J Occup Med Environ Health 2012, 25(1):41-50.
  • [10]Mitchell T, O'Sullivan PB, Burnett AF, Straker L, Rudd C: Low back pain characteristics from undergraduate student to working nurse in Australia: a cross-sectional survey. Int J Nurs Stud 2008, 45(11):1636-1644.
  • [11]Sikiru L, Hanifa S: Prevalence and risk factors of low back pain among nurses in a typical Nigerian hospital. Afr Health Sci 2010, 10(1):26-30.
  • [12]Chiou WK, Wong MK, Lee YH: Epidemiology of low back pain in Chinese nurses. Int J Nurs Stud 1994, 31(4):361-368.
  • [13]June KJ, Cho S-H: Low back pain and work-related factors among nurses in intensive care units. J Clin Nurs 2011, 20(3–4):479-487.
  • [14]Briggs AM, Bragge P, Smith AJ, Govil D, Straker LM: Prevalence and associated factors for thoracic spine pain in the adult working population: a literature review. J Occup Health 2009, 51(3):177-192.
  • [15]Schofield D, Kelly S, Shrestha R, Callander E, Passey M, Percival R: The impact of back problems on retirement wealth. Pain 2012, 153(1):203-210.
  • [16]Denis S, Shannon HS, Wessel J, Stratford P, Weller I: Association of low back pain, impairment, disability & work limitations in nurses. J Occup Rehabil 2007, 17(2):213-226.
  • [17]Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003, 290:2443-2454.
  • [18]Arthritis and Osteoporosis Victoria: A problem worth solving. Elsternwick: Arthritis and Osteoporosis Victoria; 2013.
  • [19]Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G: Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 2001, 26(22):2504-2513. discussion 2513–2504
  • [20]Walsh NE, Brooks P, Hazes JM, Walsh RM, Dreinhofer K, Woolf AD, Akesson K, Lidgren L: Standards of care for acute and chronic musculoskeletal pain: the Bone and Joint Decade (2000–2010). Arch Phys Med Rehabil 2008, 89(9):1830-1845.
  • [21]Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR: Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women. BMC Musculoskelet Disord 2008, 9:148.
  • [22]Fritz JM, George SZ, Delitto A: The role of fear-avoidance beliefs in acute low back pain: Relationships with current and future disability and work status. Pain 2001, 94:7-15.
  • [23]Waddell G, Newton M, Henderson I, Somerville D, Main CJ: A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993, 52:157-168.
  • [24]Briggs AM, Jordan JE, Buchbinder R, Burnett AF, O'Sullivan PB, Chua JY, Osborne RH, Straker LM: Health literacy and beliefs among a community cohort with and without chronic low back pain. Pain 2010, 150(2):275-283.
  • [25]Daykin AR, Richardson B: Physiotherapists’ pain beliefs and their influence on the management of patients with chronic low back pain. Spine 2004, 29:783-795.
  • [26]Linton SJ, Vlaeyen J, Ostelo R: The back pain beliefs of health care providers: are we fear-avoidant? J Occup Rehabil 2002, 12:223-232.
  • [27]Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A: The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain 2012, 16(1):3-17.
  • [28]Buchbinder R, Staples M, Jolley D: Doctors with a special interest in back pain have poorer knowledge about how to treat back pain. Spine 2009, 34(11):1218-1226. discussion 1227
  • [29]Briggs AM, Slater H, Smith AJ, Parkin-Smith GF, Watkins K, Chua J: Low back pain-related beliefs and likely practice behaviours among final-year cross-discipline health students. Eur J Pain 2013, 17(5):766-775.
  • [30]Coudeyre E, Rannou F, Tubach F, Baron G, Coriat F, Brin S, Revel M, Poiraudeau S: General practitioners’ fear-avoidance beliefs influence their management of patients with low back pain. Pain 2006, 124:330-337.
  • [31]Pincus T, Foster NE, Vogel S, Santos R, Breen A, Underwood M: Attitudes to back pain amongst musculoskeletal practitioners: a comparison of professional groups and practice settings using the ABS-mp. Man Ther 2007, 12(2):167-175.
  • [32]Houben RM, Vlaeyen JW, Peters M, Ostelo RW, Wolters PM, Stomp-van den Berg SG: Health care providers’ attitudes and beliefs towards common low back pain: factor structure and psychometric properties of the HC-PAIRS. Clin J Pain 2004, 20(1):37-44.
  • [33]Vlaeyen JW, Linton SJ: Are we “fear-avoidant"? Pain 2006, 124:240-241.
  • [34]Buchbinder R, Jolley D, Wyatt M: Effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice. Spine 2001, 26:2535-2542.
  • [35]Burnett A, Sze CC, Tam SM, Yeung KM, Leong M, Wang W, Tan BK, O'Sullivan P: A cross-cultural study of the back pain beliefs of female undergraduate healthcare students. Clin J Pain 2009, 25(1):20-28.
  • [36]Briggs AM, Jordan JE, O'Sullivan PB, Buchbinder R, Burnett AF, Osborne RH, Straker LM: Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: an assessment of health literacy. BMC Musculokelet Disord 2011, 12:161.
  • [37]Briggs AM, Slater H, Bunzli S, Jordan JE, Davies SJ, Smith AJ, Quintner JL: Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours. BMC Health Serv Res 2012, 12:357.
  • [38]Slater H, Briggs AM, Bunzli S, Davies SJ, Smith AJ, Quintner JL: Engaging consumers living in remote areas of Western Australia in the self-management of back pain: a prospective cohort study. BMC Musculokelet Disord 2012, 13:69.
  • [39]Main CJ, Waddell G: Beliefs about back pain. In The back pain revolution. Edited by Waddell G. London: Churchill Livingstone; 2004:221-240.
  • [40]Main CJ, Foster N, Buchbinder R: How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 2010, 24(2):205-217.
  • [41]Chan B, Parker G: Some recommendations to assess depression in Chinese people in Australasia. Aust N Z J Psychiatry 2004, 38:141-147.
  • [42]Chun KM, Chesla CA: Cultural issues in disease management for Chinese Americans with type 2 diabetes. Psych Health 2004, 19:767-785.
  • [43]Jones RS, Chow TW, Gatz M: Asian Americans and Alzheimer's disease: assimilation, culture, and beliefs. J Aging Stud 2006, 20:11-25.
  • [44]Fang ZZ: Potential of China in global nurse migration. Health Serv Res 2007, 42(3 Pt 2):1419-1428.
  • [45]Jin K, Sorock GS, Courtney T, Liang Y, Yao Z, Matz S, Ge L: Risk factors for work-related low back pain in the People's Republic of China. Int J Occup Environ Health 2000, 6(1):26-33.
  • [46]Jin K, Sorock GS, Courtney TK: Prevalence of low back pain in three occupational groups in Shanghai, People's Republic of China. J Safety Res 2004, 35(1):23-28.
  • [47]Barrero LH, Hsu YH, Terwedow H, Perry MJ, Dennerlein JT, Brain JD, Xu X: Prevalence and physical determinants of low back pain in a rural Chinese population. Spine 2006, 31(23):2728-2734.
  • [48]Yi H, Ji X, Wei X, Chen Z, Wang X, Zhu X, Zhang W, Chen J, Zhang D, Li M: Reliability and validity of Simplified Chinese version of Roland-Morris questionnaire in evaluating rural and urban patients with low back pain. PLoS One 2012, 7(1):e30807.
  • [49]Wang J, Ma J (Eds): Shanghai Statistical Yearbook. 1994–2013 China Academic Journal Electronic Publishing House; 2013. http://www.cnki.net webcite
  • [50]Wang Y (Ed): 2012 Jin Shan Yearbook: Jin Shan Overview. 1994–2013 China Academic Journal Electronic Publishing House; 2012. http://www.cnki.net webcite
  • [51]Schwarz MR, Wojtczak A, Zhou T: Medical education in China's leading medical schools. Med Teach 2004, 26(3):215-222.
  • [52]Chen G, Tan BK, Jia HL, O'Sullivan P, Burnett A: Questionnaires to examine Back Pain Beliefs held by health care professionals: a psychometric evaluation of Simplified Chinese versions. Spine 2011, 36(18):1505-1511.
  • [53]Symonds TL, Burton AK, Tillotson KM, Main CJ: Do attitudes and beliefs influence work loss due to low back trouble? Occup Med (Lond) 1996, 46:25-32.
  • [54]Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K: Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987, 18(3):233-237.
  • [55]Dawson AP, Steele EJ, Hodges PW, Stewart S: Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. J Pain 2009, 10(5):517-526.
  • [56]Ogon M, Krismer M, Sollner W, Kantner-Rumplmair W, Lampe A: Chronic low back pain measurement with visual analogue scales in different settings. Pain 1996, 64(3):425-428.
  • [57]Roland M, Fairbank J: The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine 2000, 25:3115-3124.
  • [58]Fan SW, Hu ZA, Hong H, Zhao FD: Cross-cultural adaptation and validation of Simplified Chinese version of the Roland-Morris Disability Questionnaire. Spine (Phila Pa 1976) 2012, 37(10):875.
  • [59]Turner JA, Franklin G, Fulton-Kehoe D, Sheppard L, Wickizer TM, Wu R, Gluck JV, Egan K: Worker recovery expectations and fear-avoidance predict work disability in a population-based workers’ compensation back pain sample. Spine 2006, 31(6):682-689.
  • [60]George SZ, Fritz JM, McNeil DW: Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain. Clin J Pain 2006, 22:197-203.
  • [61]Smith AJ, O'Sullivan PB, Beales D, Straker L: Back pain beliefs are related to the impact of low back pain in 17-year-olds. Phys Ther 2012, 92(10):1258-1267.
  • [62]Chou R, Huffman LH, American Pain S, American College of P: Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med 2007, 147(7):492-504.
  • [63]Bowey-Morris J, Davis S, Purcell-Jones G, Watson PJ: Beliefs about back pain: results of a population survey of working age adults. Clin J Pain 2011, 27(3):214-224.
  • [64]Coudeyre E, Tubach F, Rannou F, Baron G, Coriat F, Brin S, Revel M, Poiraudeau S: Fear-avoidance beliefs about back pain in patients with acute LBP. Clin J Pain 2007, 23:720-725.
  • [65]Slater H, Briggs AM, Smith AJ, Bunzli S, Davies SJ, Quintner JL: Implementing Evidence-Informed Policy into Practice for Health Care Professionals Managing People with Low Back Pain in Australian Rural Settings: A Preliminary Prospective Single-Cohort Study. Pain Med 2014. doi:10.1111/pme.12351. [Epub ahead of print]
  • [66]Rarick CA: Confucius on Management: Understanding Chinese Cultural Values and Managerial Practices. J Int Manag Stud 2007, August:22-28.
  • [67]Ferreira PH, Ferreira ML, Latimer J, Maher CG, Refshauge K, Sakamoto A, Garofalo R: Attitudes and beliefs of Brazilian and Australian physiotherapy students towards chronic back pain: A cross-cultural comparison. Physiother Res Int 2004, 9:13-23.
  • [68]Sions JM, Hicks GE: Fear-avoidance beliefs are associated with disability in older American adults with low back pain. Phys Ther 2011, 91(4):525-534.
  • [69]Camacho-Soto A, Sowa GA, Perera S, Weiner DK: Fear avoidance beliefs predict disability in older adults with chronic low back pain. PM R 2012, 4(7):493-497.
  • [70]Jensen JN, Karpatschof B, Labriola M, Albertsen K: Do fear-avoidance beliefs play a role on the association between low back pain and sickness absence? A prospective cohort study among female health care workers. J Occup Environ Med 2010, 52(1):85-90.
  • [71]Rainville J, Smeets RJ, Bendix T, Tveito TH, Poiraudeau S, Indahl AJ: Fear-avoidance beliefs and pain avoidance in low back pain–translating research into clinical practice. Spine J 2011, 11(9):895-903.
  • [72]Vlaeyen JW, Linton SJ: Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 2012, 153(6):1144-1147.
  • [73]Domenech J, Sanchez-Zuriaga D, Segura-Orti E, Espejo-Tort B, Lison JF: Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: a randomised clinical trial. Pain 2011, 152(11):2557-2563.
  • [74]Kovacs F, Abraira V, Cano A, Royuela A, Gil del Real MT, Gestoso M, Mufraggi N, Muriel A, Zamora J: Fear avoidance beliefs do not influence disability and quality of life in Spanish elderly subjects with low back pain. Spine 2007, 32(19):2133-2138.
  • [75]Bishop A, Foster NE, Thomas E, Hay EM: How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain 2008, 135(1–2):187-195.
  • [76]Poiraudeau S, Rannou F, Baron G, Le Henanff A, Coudeyre E, Rozenberg S, Huas D, Martineau C, Jolivet-Landreau I, Garcia-Macé J, Revel M, Ravaud P: Fear-avoidance beliefs about back pain in patients with subacute low back pain. Pain 2006, 124:305-311.
  • [77]Kent PM, Keating JL, Buchbinder R: Searching for a conceptual framework for nonspecific low back pain. Man Ther 2009, 14(4):387-396.
  • [78]Gross DP, Ferrari R, Russell AS, Battié MC, Schopflocher D, Hu RW, Waddell G, Buchbinder R: A population-based survey of back pain beliefs in Canada. Spine 2006, 31:2142-2145.
  • [79]Buchbinder R, Jolley D: Improvements in general practitioner beliefs and stated management of back pain persist 4.5 years after the cessation of a public health media campaign. Spine 2007, 32:E156-E162.
  • [80]George SZ, Teyhen DS, Wu SS, Wright AC, Dugan JL, Yang G, Robinson ME, Childs JD: Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting. Eur Spine J 2009, 18(7):1050-1058.
  文献评价指标  
  下载次数:1次 浏览次数:5次