Psychological risk and protective factors for disability in chronic low back pain – a longitudinal analysis in primary care

BMC Musculoskeletal Disorders

Research Article

Annika Viniol¹  Erika Baum¹  Corinna Leonhardt¹  Annette Becker¹  Nikita Roman A. Jegan¹  Jürgen Barth²  Konstantin Strauch³  Markus Brugger³ 

[1] Department of General Practice and Family Medicine, Philipps-University Marburg, Karl-von-Frisch-Str. 4, 35032, Marburg, Germany;Institute for Complementary and Integrative Medicine, University Hospital Zurich und University Zurich, Zurich, Switzerland;Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany;Institute of Genetic Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany;

关键词: Chronic low back pain;    Longitudinal study;    Primary care;    Resilience;    Self-efficacy;   

DOI  :  10.1186/s12891-017-1482-8

 received in 2016-08-30, accepted in 2017-03-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUtilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability. The observational study at hand examined the longitudinal impact of resilience and coping resources on disability in addition to established risk factors.MethodsFour hundred eighty four patients with chronic low back pain (>3 months) were recruited in primary care practices and followed up for one year. Resilience, coping, depression, somatization, pain and demographic variables were measured at baseline. At follow-up (participation rate 89%), data on disability was collected. We first calculated bivariate correlations of all the predictors with each other and with follow-up disability. We then used a multiple regression to evaluate the impact of all the predictors on disability together.ResultsMore than half of the followed up sample showed a high degree of disability at baseline (53.7%) and had suffered for more than 10 years from pain (50.4%). Besides gender all of the predictors were bivariately associated with follow-up disability. However in the main analysis (multiple regression), disability at follow up was only predicted by baseline disability, age and somatization. There was no relationship between resilience and disability, nor between coping resources and disability.ConclusionsAlthough it is known that there are cross-sectional relationships between resilience/coping resources and disability we were not able to replicate it in the multiple regression. This can have several reasons: a) the majority of patients in our sample were much more disabled and suffered for a longer time than in other studies. Therefore our results might be limited to this specific population and resilience and coping resources might still have a protective influence in acute or subacute populations. b) We used a rather broad operationalization of resilience. There is emerging evidence that focusing on more concrete sub facets like (pain) self-efficacy and acceptance might be more beneficial.Trial registrationGerman Clinical Trial Register, DRKS00003123 (June 28th 2011).

【 授权许可】

CC BY   
© The Author(s). 2017