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Gusler S, Guler J, Petrie R, Marshall H, Cooley D, Jackson Y. Adversity Interpreted: A Scoping Review of Adversity Appraisal Measurement. TRAUMA, VIOLENCE & ABUSE 2022; 23:1111-1133. [PMID: 33511918 DOI: 10.1177/1524838020985544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although evidence suggests that individuals' appraisals (i.e., subjective interpretations) of adverse or traumatic life events may serve as a mechanism accounting for differences in adversity exposure and psychological adjustment, understanding this mechanism is contingent on our ability to reliably and consistently measure appraisals. However, measures have varied widely between studies, making conclusions about how best to measure appraisal a challenge for the field. To address this issue, the present study reviewed 88 articles from three research databases, assessing adults' appraisals of adversity. To be included in the scoping review, articles had to meet the following criteria: (1) published no earlier than 1999, (2) available in English, (3) published as a primary source manuscript, and (4) included a measure assessing for adults' (over the age of 18) subjective primary and/or secondary interpretations of adversity. Each article was thoroughly reviewed and coded based on the following information: study demographics, appraisal measurement tool(s), category of appraisal, appraisal dimensions (e.g., self-blame, impact, and threat), and the tool's reliability and validity. Further, information was coded according to the type of adversity appraised, the time in which the appraised event occurred, and which outcomes were assessed in relation to appraisal. Results highlight the importance of continued examination of adversity appraisals and reveal which appraisal tools, categories, and dimensions are most commonly assessed for. These results provide guidance to researchers in how to examine adversity appraisals and what gaps among the measurement of adversity appraisal which need to be addressed in the future research.
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Affiliation(s)
| | | | | | | | - Daryl Cooley
- Pennsylvania State University, State College, PA, USA
| | - Yo Jackson
- Pennsylvania State University, State College, PA, USA
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Puschmann AK, Drießlein D, Beck H, Arampatzis A, Moreno Catalá M, Schiltenwolf M, Mayer F, Wippert PM. Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study. J Pain Res 2020; 13:613-621. [PMID: 32280264 PMCID: PMC7125403 DOI: 10.2147/jpr.s223893] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/20/2020] [Indexed: 01/12/2023] Open
Abstract
Purpose Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (±13.4) years; baseline pain intensity: 27.8 (±18.4); disability: 14.3 (±17.9)). In the 1-year follow-up, the stress types “tendency to worry”, “social isolation”, “work discontent” as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types “tendency to worry”, “social isolation”, “social conflicts”, and “perceived long-term stress” as potential risk factors for both pain intensity and disability. Furthermore, “self-efficacy” (“internality”, “self-concept”) and “social externality” play a role in reducing pain-related disability. Conclusion Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.
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Affiliation(s)
| | - David Drießlein
- Statistical Consulting Unit, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Heidrun Beck
- University Center of Orthopedics and Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-University of Berlin, Berlin, Germany
| | - Maria Moreno Catalá
- Department of Training and Movement Sciences, Humboldt-University of Berlin, Berlin, Germany
| | - Marcus Schiltenwolf
- Conservative Orthopaedics and Pain Management, Center of Orthopaedics and Trauma Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Frank Mayer
- University Outpatient Clinic, University of Potsdam, Potsdam, Germany
| | - Pia-Maria Wippert
- Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany.,Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
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Heidari J, Mierswa T, Hasenbring M, Kleinert J, Levenig C, Belz J, Kellmann M. Recovery-stress patterns and low back pain: Differences in pain intensity and disability. Musculoskeletal Care 2018; 16:18-25. [PMID: 28394033 DOI: 10.1002/msc.1195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Recovery describes a restoring process influencing the health conditions of individuals but a potential link to low back pain (LBP) has not been scrutinized so far. Psychological strategies to deal with LBP have been considered within the biopsychosocial approach but substantial evidence regarding specific psychological underpinnings remains elusive. The current study aimed to compare individuals with different recovery-stress patterns (i.e. specific combinations of recovery/stress) regarding their pain and disability in the lower back. METHODS Cross-sectional data from 265 physically active individuals with non-specific LBP were collected via standardized questionnaires. The participants engaged in prescribed exercise therapy provided by a healthcare professional owing to their back burden. A k-means cluster analysis identified three clusters. RESULTS Cluster 1 entailed individuals with high recovery and low stress values, Cluster 2 represented participants with medium scores on both dimensions and Cluster 3 included participants with low recovery and high stress values. The statistical analyses for pain intensity using analyses of covariance indicated significantly higher values for Cluster 3 compared with Clusters 1 and 2 for worst pain intensity (p < 0.001 and p = 0.003, respectively) and mean pain intensity (p < 0.001 and p = 0.001, respectively). The disability comparisons using non-parametric tests showed significantly higher LBP-related disability in Cluster 3 than Cluster 1 on two disability measures. CONCLUSIONS The findings indicate an association between detrimental recovery-stress patterns and LBP. Examining the role of recovery has innovative practical relevance for LBP prevention and rehabilitation through the implementation of approaches to enhance recovery in relevant programmes.
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Affiliation(s)
- Jahan Heidari
- Unit of Sport Psychology, Ruhr University, Bochum, Germany
| | - Tobias Mierswa
- Unit of Sport Psychology, Ruhr University, Bochum, Germany
| | - Monika Hasenbring
- Department of Medical Psychology and Medical Sociology, Ruhr University, Bochum, Germany
| | - Jens Kleinert
- Department of Health & Social Psychology, German Sport University, Cologne, Germany
| | - Claudia Levenig
- Department of Medical Psychology and Medical Sociology, Ruhr University, Bochum, Germany
| | - Johanna Belz
- Department of Health & Social Psychology, German Sport University, Cologne, Germany
| | - Michael Kellmann
- Unit of Sport Psychology, Ruhr University, Bochum, Germany
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
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Courbalay A, Tétreau C, Lardon A, Deroche T, Cantin V, Descarreaux M. Contribution of Load Expectations to Neuromechanical Adaptations During a Freestyle Lifting Task: A Pilot Study. J Manipulative Physiol Ther 2017; 40:547-557. [DOI: 10.1016/j.jmpt.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/20/2017] [Accepted: 07/20/2017] [Indexed: 10/18/2022]
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Billis E, Koutsojannis C, Matzaroglou C, Gliatis J, Fousekis K, Gioftsos G, Papandreou M, McCarthy C, Oldham JA, Tsepis E. Association of low back pain on physical, sociodemographic and lifestyle factors across a general population sample within Greece. J Back Musculoskelet Rehabil 2017; 30:279-290. [PMID: 27689603 DOI: 10.3233/bmr-150484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although low back pain (LBP) is a debilitating problem internationally, there is not a lot of research on its impact on physical, psychosocial and lifestyle factors. Especially in mediterranean countries, such as Greece, it is not sufficiently explored whether physical (pain location, activity limitation etc.), sociodemographic (education, smoking etc.) or lifestyle factors (i.e. quality of life or anxiety) are influenced by LBP. OBJECTIVE To estimate LBP prevalence in the Greek general population and explore its association with particular sociodemographic, physical and lifestyle factors. METHOD A sample of 3125 people of the Greek adult population was randomly selected by stratified sampling encompassing rural and urban representation within the Greek mainland. An extended survey form was developed entailing three sections; personal (sociodemographic) information, questions on symptomatology and physical factors (i.e. pain characteristics, recurrence, physical disability etc.) and 3 self-administered questionnaires (including mostly lifestyle factors); Hospital Anxiety and Depression (HAD) scale for anxiety and depression, SF-12 for quality of life (QoL) and Roland-Morris for disability. RESULTS A total of 471 (15%) people reported LBP (210 males, mean age: 47.04 ± 15.03). Amongst them 60% reported sciatica, 76% suffered recurrent LBP and 70% received specialist care. Low disability levels, moderate to high pain intensity, gender differences and good self-reported QoL and psychosocial status were reported. Sociodemographic characteristics (income, smoking, marital status etc.) were not associated with LBP physical factors, apart from age which correlated with physical disability and wellness (r being 0.446 and 0.405, respectively, p< 0.001). Physical factors (particularly pain intensity and location) correlated with lifestyle factors (QoL) and disability (r ranging between 0.396 and 0.543, p< 0.001). Mental wellness, anxiety and depression (as lifestyle factors) were not associated with sociodemographic or physical factors. CONCLUSIONS Physical parameters were amongst the most prevalent characteristics of the Greek sample, thus offering a direction towards a more targeted treatment and rehabilitation planning. Unlike previous literature, most sociodemographic characteristics were not correlated with any LBP physical or lifestyle factors, thus possibly indicating a different socioeconomic background and aetiology domain to that of the usual non-specific LBP spectrum.
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Affiliation(s)
- E Billis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - C Koutsojannis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - C Matzaroglou
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - J Gliatis
- Orthopaedic Department, University Hospital of Patras, Greece
| | - K Fousekis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
| | - G Gioftsos
- Department of Physiotherapy, Technological Educational Institute (T.E.I) of Sterea Ellada, Greece
| | - M Papandreou
- Department of Physiotherapy, Technological Educational Institute (T.E.I.) of Athens, Greece
| | - C McCarthy
- Imperial College Healthcare NHS Trust, London, UK
| | - J A Oldham
- University of Manchester, Manchester, UK
| | - E Tsepis
- Department of Physical Therapy, Technological Educational Institute (T.E.I.) of Western Greece, Greece
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Heidari J, Hasenbring M, Kleinert J, Kellmann M. Stress-related psychological factors for back pain among athletes: Important topic with scarce evidence. Eur J Sport Sci 2016; 17:351-359. [PMID: 27838957 DOI: 10.1080/17461391.2016.1252429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Health issues represent a frequent problem for athletes, as this particular demographic is repeatedly confronted with physically and psychologically stressful situations. Back pain (BP) materialises as comparatively common health problem being regarded as functionally limiting and psychologically straining burden for athletes. According to research conducted on athletes with BP, biomechanical and physiological mechanisms emerge as influential, whereas stress-related psychological factors appear to be neglected. For athletic injuries, the essential impact of psychological processes on injury occurrence and return from injury has already been corroborated. Hence, the aim of this literature review is to: (1) introduce a conceptual differentiation between injuries and BP; (2) summarise the results obtained regarding stress-related psychological aspects for injuries; and (3) connect the injury research to the state-of-the-art evidence regarding stress-related factors for BP among athletes. A distinction between injuries and BP could be established based on previous definitions, despite the fact that a considerable overlap between both concepts prevails. Injuries can be attributed to a physical origin, whereas BP frequently lacks this physical criterion. For BP, our enquiry yielded four studies including psychological measures of stress - with two studies specifically examining the association between BP and psychological stress among athletes longitudinally. Abundant findings from the general population support the importance of considering psychological and specifically stress-related factors in BP prevention and rehabilitation, but evidence related to the athletic field remains elusive. Further scientific investigations with a wider methodological approach are needed to deepen the knowledge about the crucial relationship between psychological stress, BP, and athletes.
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Affiliation(s)
- Jahan Heidari
- a Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Germany
| | - Monika Hasenbring
- b Department of Medical Psychology and Medical Sociology , Ruhr University Bochum , Germany
| | - Jens Kleinert
- c Department of Health and Social Psychology , German Sport University , Cologne , Germany
| | - Michael Kellmann
- a Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Germany.,d School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
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Kururi N, Tozato F, Lee B, Kazama H, Katsuyama S, Takahashi M, Abe Y, Matsui H, Tokita Y, Saitoh T, Kanaizumi S, Makino T, Shinozaki H, Yamaji T, Watanabe H. Professional identity acquisition process model in interprofessional education using structural equation modelling: 10-year initiative survey. J Interprof Care 2016; 30:175-83. [PMID: 26930464 DOI: 10.3109/13561820.2015.1092117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The mandatory interprofessional education (IPE) programme at Gunma University, Japan, was initiated in 1999. A questionnaire of 10 items to assess the students' understanding of the IPE training programme has been distributed since then, and the factor analysis of the responses revealed that it was categorised into four subscales, i.e. "professional identity", "structure and function of training facilities", "teamwork and collaboration", and "role and responsibilities", and suggested that these may take into account the development of IPE programme with clinical training. The purpose of this study was to examine the professional identity acquisition process (PIAP) model in IPE using structural equation modelling (SEM). Overall, 1,581 respondents of a possible 1,809 students from the departments of nursing, laboratory sciences, physical therapy, and occupational therapy completed the questionnaire. The SEM technique was utilised to construct a PIAP model on the relationships among four factors. The original PIAP model showed that "professional identity" was predicted by two factors, namely "role and responsibilities" and "teamwork and collaboration". These two factors were predicted by the factor "structure and function of training facilities". The same structure was observed in nursing and physical therapy students' PIAP models, but it was not completely the same in laboratory sciences and occupational therapy students' PIAP models. A parallel but not isolated curriculum on expertise unique to the profession, which may help to understand their professional identity in combination with learning the collaboration, may be necessary.
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Affiliation(s)
- Nana Kururi
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Fusae Tozato
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Bumsuk Lee
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Hiroko Kazama
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Shiori Katsuyama
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Maiko Takahashi
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Yumiko Abe
- b Department of Laboratory Sciences , Gunma University , Maebashi , Japan
| | - Hiroki Matsui
- b Department of Laboratory Sciences , Gunma University , Maebashi , Japan
| | - Yoshiharu Tokita
- b Department of Laboratory Sciences , Gunma University , Maebashi , Japan
| | - Takayuki Saitoh
- b Department of Laboratory Sciences , Gunma University , Maebashi , Japan
| | - Shiomi Kanaizumi
- c Department of Nursing, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Takatoshi Makino
- c Department of Nursing, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Hiromitsu Shinozaki
- c Department of Nursing, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Takehiko Yamaji
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
| | - Hideomi Watanabe
- a Department of Rehabilitation Sciences, Graduate School of Health Sciences , Gunma University , Maebashi , Japan
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Manchikanti L, Singh V, Falco FJE, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation 2015; 17 Suppl 2:3-10. [PMID: 25395111 DOI: 10.1111/ner.12018] [Citation(s) in RCA: 312] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 11/07/2012] [Accepted: 11/25/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Low back pain affects many individuals. It has profound effects on well-being and is often the cause of significant physical and psychological health impairments. Low back pain also affects work performance and social responsibilities, such as family life, and is increasingly a major factor in escalating health-care costs. A global review of the prevalence of low back pain in the adult general population has shown its point prevalence to be approximately 12%, with a one-month prevalence of 23%, a one-year prevalence of 38%, and a lifetime prevalence of approximately 40%. Furthermore, as the population ages over the coming decades, the number of individuals with low back pain is likely to increase substantially. This comprehensive review is undertaken to assess the increasing prevalence of low back pain and the influence of comorbid factors, along with escalating costs. MATERIALS AND METHODS A narrative review with literature assessment. RESULTS In the USA, low back pain and related costs are escalating. Based on the available literature, it appears that the prevalence of low back pain continues to increase, along with numerous modalities and their application in managing low back pain. Comorbid factors with psychological disorders and multiple medical problems, including obesity, smoking, lack of exercise, increasing age, and lifestyle factors, are considered as risk factors for low back pain. CONCLUSION Although it has been alleged that low back pain resolves in approximately 80% to 90% of patients in about six weeks, irrespective of the administration or type of treatment, with only 5% to 10% of patients developing persistent back pain, this concept has been frequently questioned as the condition tends to relapse and most patients experience multiple episodes years after the initial attack.
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Affiliation(s)
- Laxmaiah Manchikanti
- Pain Management Center of Paducah, Paducah, KY, USA; University of Louisville, Louisville, KY, USA
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Besen E, Young AE, Shaw WS. Returning to work following low back pain: towards a model of individual psychosocial factors. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:25-37. [PMID: 24846078 PMCID: PMC4333236 DOI: 10.1007/s10926-014-9522-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE The aim of this paper is to develop and test a model of direct and indirect relationships among individual psychosocial predictors of return-to-work (RTW) outcomes following the onset of low back pain (LBP). METHODS We utilize secondary analysis of a larger study of adults seeking treatment for work-related LBP with recent onset. In total, 241 participants who completed a baseline survey, a short follow-up survey, and a longer follow-up survey after 3 months were included in our analyses. The participants were required to have LBP with onset of less than 14 days, be 18 years or older, and be fluent in English or Spanish. The analyses utilized structural equation models to test the direct and indirect relationships among the variables and RTW outcomes at 3 months. RESULTS Our results indicated a good fit for our model (χ2 = 69.59, df = 45, p < .05; RMSEA = .05; CFI = .95; WRMR = .61). Pain, catastrophizing, fear-avoidance beliefs, organizational support, and RTW confidence were all found to have indirect relationships with the outcomes. RTW confidence and RTW expectations were found to have direct relationships with the outcomes. CONCLUSIONS The process of returning to work after an episode of LBP is a complex process involving many interrelated factors. Understanding the relationships among critical individual factors in the RTW process may be important for the treatment and rehabilitation of those with LBP. Results suggest that if injured workers are struggling with fear avoidance, pain catastrophizing and confidence issues, they might benefit from the application of cognitive behavioral therapy techniques.
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Affiliation(s)
- Elyssa Besen
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA,
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10
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Abstract
Psychosoziale Arbeitsbedingungen, wie Arbeitsstressoren und –ressourcen, stehen im engen Zusammenhang mit der Entstehung von Rückenschmerzen. Die Wahrnehmung und der Umgang mit den Arbeitsbedingungen hängen jedoch stark von dem eigenen Erholungszustand und besonders von der Fähigkeit ab, sich in der Freizeit von belastenden Arbeitsbedingungen zu distanzieren (Detachment). Ziel der vorliegenden Studie war es, den Einfluss von Detachment auf den Zusammenhang von psychosozialen Arbeitsbedingungen und Rückenschmerz genauer zu untersuchen. Zu diesem Zweck wurde eine Onlinebefragung bei insgesamt 647 Verwaltungsangestellten von 13 Hochschulen in NRW durchgeführt. Die Befragten wurden in zwei Gruppen, eine mit Rückenbeschwerden und eine ohne Rückenbeschwerden, unterteilt. Personen mit Rückenschmerzen zeigten deutlich ungünstigere Arbeitsbedingungen auf und hatten niedrigere Detachment-Werte. Zudem konnte mittels logistischer Regressionsanalyse der moderierende Einfluss von Detachment auf den Zusammenhang von Arbeitsstressoren mit Rückenschmerzen bestätigt werden. Auch der Zusammenhang zwischen dem Organisationsklima und Rückenschmerzen wurde durch Detachment moderiert. Der Einfluss des Detachments war dabei besonders ausgeprägt, wenn die Arbeitnehmer/innen starken Belastungen durch Arbeitsstressoren und einem unterstützenden Organisationsklima ausgesetzt waren.
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Affiliation(s)
- Tobias Mierswa
- Lehr- und Forschungsbereich Sportpsychologie, Ruhr-Universität Bochum
| | - Michael Kellmann
- Lehr- und Forschungsbereich Sportpsychologie, Ruhr-Universität Bochum
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Boyle JK, Anthony IC, Jones BG, Wheelwright EF, Blyth MJG. Influence of low back pain on total knee arthroplasty outcome. Knee 2014; 21:410-4. [PMID: 24457058 DOI: 10.1016/j.knee.2013.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 12/05/2013] [Accepted: 12/16/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Preoperative pain and functional status are strong determinants of postsurgical success in total knee arthroplasty. Patients suffering chronic pain from other coexistent musculoskeletal problems may respond differently postoperatively, with potentially poorer outcomes after surgery. The aim of the study was to determine the influence of low back pain on the outcome of total knee replacement surgery. METHODS All patients completed Oxford Knee Scores (OKS), American Knee Society Scores (AKSS) and SF-12 (both physical and mental components). Patients were divided into those with (n=40) and without a documented history of low back pain (n=305). RESULTS OKS, AKSS and SF-12 physical scores were significantly worse for patients with low back pain at 24 months following surgery. The mental component of the SF-12 measure demonstrated a significant improvement in median mental health post-operatively for patients with no current history of low back pain. In contrast the group with low back pain showed no improvement in mental health scores post-operatively. CONCLUSION This study demonstrates that symptomatic low back pain influences functional outcome after total knee arthroplasty surgery and that patients with low back pain show limited or no improvement in mental health post-operatively. Level of evidence II.
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Affiliation(s)
- J K Boyle
- Orthopaedic Research Unit, Department of Trauma and Orthopaedics, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom
| | - I C Anthony
- Orthopaedic Research Unit, Department of Trauma and Orthopaedics, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom
| | - B G Jones
- Orthopaedic Research Unit, Department of Trauma and Orthopaedics, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom
| | - E F Wheelwright
- Orthopaedic Research Unit, Department of Trauma and Orthopaedics, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom
| | - M J G Blyth
- Orthopaedic Research Unit, Department of Trauma and Orthopaedics, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom.
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Cheshire A, Polley M, Peters D, Ridge D. Patient outcomes and experiences of an acupuncture and self-care service for persistent low back pain in the NHS: a mixed methods approach. Altern Ther Health Med 2013; 13:300. [PMID: 24180515 PMCID: PMC3827006 DOI: 10.1186/1472-6882-13-300] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 10/14/2013] [Indexed: 11/29/2022]
Abstract
Background Supported self-management, acupuncture and information can help reduce the symptoms of low back pain. These approaches are currently recommended by NICE guidance as treatment options for patients with persistent low back pain. However, there has been no previous evaluation of a service providing them together for this common problem. The purpose of this service evaluation was to report patient outcomes and experiences of the Beating Back Pain Service (BBPS), a pilot service based in a primary and community care setting, delivering acupuncture, self-management and information to patients with chronic low back pain. Methods Patients completed a questionnaire at three time points: pre-BBPS, immediately post-BBPS and three months post-BBPS. Outcome measures included the Bournemouth Questionnaire (measuring musculoskeletal, MSK, problems), EuroQoL-5D (measuring quality of life), Pain and Self-efficacy Questionnaire, and additional questions on medication use, physical activity, understanding of pain and positive well-being. Additionally, the STarT Back (measuring risk of developing chronic pain) was collected at BBPS information sessions. Non-parametric tests were used to evaluate pre- and post- variables. Questionnaires also collected qualitative data (open-text responses) regarding patient views and experiences of the BBPS, which were analysed using thematic analysis. Results 80 (out of 108) patients who attended the initial BBPS information session agreed to participate in the service evaluation (mean age 47 years, 65% female). 65 patients attended subsequent BBPS acupuncture and/or self-management sessions and were asked to complete post-treatment questionnaires; complete datasets were available for 61 patients. There were statistically significant improvements over time for pain (p <0.0001), quality of life (p = 0.006), understanding of pain (p <0.001), physical activity (p = 0.047) and relaxation (p = 0.012). Post-hoc analysis revealed that scores improved between baseline and post-treatment, these improvements were maintained at 3-month follow-up (except relaxation). Patients receiving a combination of acupuncture and self-management sessions produced the most positive results. Patient satisfaction with the BBPS was high. Conclusions The BBPS provided a MSK pain management service that many patients found effective and valuable. Combining self-management with acupuncture was found to be particularly effective, although further consideration is required regarding how best to engage patients in self-management.
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13
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Ferreira MS, Pereira MG. The mediator role of psychological morbidity in patients with chronic low back pain in differentiated treatments. J Health Psychol 2013; 19:1197-207. [DOI: 10.1177/1359105313488970] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study analyzed the mediating role of psychological morbidity and the variables that discriminated low versus high disability, in patients receiving physiotherapy and acupuncture. A total of 203 patients answered measures of illness and medication representations, coping, depression, anxiety, quality of life, and functional disability. Morbidity was a mediator between functional disability and quality of life. Treatment consequences and quality of life, in the acupuncture group, and emotional representations, quality of life, depression, anxiety, and active strategies for pain relief, in the physiotherapy group, discriminated patients with low versus high disability. These results have important implications for identifying high-risk patients.
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Affiliation(s)
- M Salomé Ferreira
- School of Health Sciences, Polytechnic Institute of Viana do Castelo, Portugal
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Mendelek F, Caby I, Pelayo P, Kheir RB. The application of a classification-tree model for predicting low back pain prevalence among hospital staff. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2013; 68:135-144. [PMID: 23566320 DOI: 10.1080/19338244.2012.663010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Low back pain (LBP) is a widespread musculoskeletal condition that frequently occurs in the working-age population (including hospital staff). This study proposes a classification-tree model to predict LBP risk levels in Sacré-Cœur Hospital, Lebanon (as a case study-236 chosen staffs) using various predictor individual and occupational factors. The developed tree model explained 80% of variance in LBP risk levels using standing hours/day (90% in relative importance), job status/sitting hours per day (80% each), body mass index (71%), working days/week (63%), domestic activity hours/week (36%), weight (35%), job dissatisfaction/sitting on ergonomic chairs (30% each), height (28%), gender (27%), sufficient break time (26%), using handling techniques/age (25% each), job stress (24%), marital status/wearing orthopedic insoles/extra professional activity (22% each), practicing prevention measures (20%), children care hours/week (16%), and type of sport activity/sports hours per week, car sitting, and fear of changing work due to LBP (15% each). The overall accuracy of this predictive tree once compared with actual subjects was estimated to be 77%. The proposed tree model can be used by expert physicians in their decision-making for LBP diagnosis among hospital staff.
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Affiliation(s)
- Fady Mendelek
- Physiotherapy Service, Sacré-Coeur Hospital, Baabda, Lebanon.
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Ghosh T, Das B, Gangopadhyay S. A comparative ergonomic study of work-related upper extremity musculo skeletal disorder among the unskilled and skilled surgical blacksmiths in West Bengal, India. Indian J Occup Environ Med 2012; 15:127-32. [PMID: 22412291 PMCID: PMC3299097 DOI: 10.4103/0019-5278.93203] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The main aim of the study was to determine the nature and extent of work-related upper extremity musculoskeletal disorders (MSDs) and physiological stress among the blacksmiths involved in surgical instrument industry. MATERIALS AND METHODS In the present investigation, 50 male blacksmiths of each skilled and unskilled groups of the forging section had been selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and hand grip strength of both the groups were measured. RESULTS It was revealed that upper limb MSD was a major problem among both group of blacksmith, primarily involving the hand, wrist, fingers, and shoulder. From this study it was found that 66% (33) skilled and 80% (40) unskilled blacksmith workers are feeling discomfort. The most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%), neck (skilled 60% and unskilled 80%), and hand (skilled 50% and unskilled).
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Affiliation(s)
- Tirthankar Ghosh
- Department of Physiology, Manipal College of Medical Science, Pokhara, Nepal, India
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The Relationship between Beliefs about Pain and Functioning with Rheumatologic Conditions. Rehabil Res Pract 2012; 2012:206263. [PMID: 22792468 PMCID: PMC3390114 DOI: 10.1155/2012/206263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/12/2012] [Accepted: 04/29/2012] [Indexed: 11/17/2022] Open
Abstract
Pain beliefs influence understanding of pain mechanisms and outcomes. This study in rheumatologic conditions sought to determine a relationship between beliefs about pain and functioning. Participants in Arthritis New Zealand's (ANZ) exercise and education programmes were used. Demographic data and validated instruments used included the Arthritis Impact Measurement Scale 2nd version-Short Form (AIMS2-SF) to measure functioning, and two scales of organic and psychological beliefs in Pain Beliefs Questionnaires (PBQ) to measure pain beliefs. 236 Members of ANZ were surveyed anonymously with AIMS2-SF and PBQ, with a 61% response rate; 144 responses were entered into the database. This study used α of 0.05 and a 1-β of 0.8 to detect for significant effect size estimated to be r = 0.25. Analysis revealed a significant relationship between organic beliefs scale of PBQ and functioning of AIMS2-SF, with an r value of 0.32 and P value of 0.00008. No relationship was found between psychological beliefs scale of PBQ and AIMS2-SF. Organic pain beliefs are associated with poorer functioning. Psychological pain beliefs are not. Beliefs might have been modified by ANZ programmes. Clinicians should address organic pain beliefs early in consultation. Causal links between organic pain beliefs and functioning should be clarified.
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Truchon M, Schmouth MÈ, Côté D, Fillion L, Rossignol M, Durand MJ. Absenteeism screening questionnaire (ASQ): a new tool for predicting long-term absenteeism among workers with low back pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:27-50. [PMID: 21796374 DOI: 10.1007/s10926-011-9318-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Over the last decades, psychosocial factors were identified by many studies as significant predictive variables in the development of disability related to common low back disorders, which thus contributed to the development of biopsychosocial prevention interventions. Biopsychosocial interventions were supposed to be more effective than usual interventions in improving different outcomes. Unfortunately, most of these interventions show inconclusive results. The use of screening questionnaires was proposed as a solution to improve their efficacy. The aim of this study was to validate a new screening questionnaire to identify workers at risk of being absent from work for more than 182 cumulative days and who are more susceptible to benefit from prevention interventions. METHODS Injured workers receiving income replacement benefits from the Quebec Compensation Board (n = 535) completed a 67-item questionnaire in the sub-acute stage of pain and provided information about work-related events 6 and 12 months later. Reliability and validity of the 67-item questionnaire were determined respectively by test-retest reliability and internal consistency analysis, as well as by construct validity analyses. The Cox regression model and the maximum likelihood method were used to fix a model allowing calculation of a probability of absence of more than 182 days. Criterion validity and discriminative capacity of this model were calculated. RESULTS Sub-sections from the 67-item questionnaire were moderately to highly correlated 2 weeks later (r = 0.52-0.80) and showed moderate to good internal consistency (0.70-0.94). Among the 67-item questionnaire, six sub-sections and variables (22 items) were predictive of long-term absence from work: fear-avoidance beliefs related to work, return to work expectations, annual family income before-taxes, last level of education attained, work schedule and work concerns. The area under the ROC curve was 73%. CONCLUSIONS The significant predictive variables of long-term absence from work were dominated by workplace conditions and individual perceptions about work. In association with individual psychosocial variables, these variables could contribute to identify potentially useful prevention interventions and to reduce the significant costs associated with LBP long-term absenteeism.
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Affiliation(s)
- Manon Truchon
- Département des Relations Industrielles, Université Laval, Québec, Canada.
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Jackson T, Yang Z, Li X, Chen H, Huang X, Meng J. Coping when pain is a potential threat: the efficacy of acceptance versus cognitive distraction. Eur J Pain 2011; 16:390-400. [PMID: 22337145 DOI: 10.1002/j.1532-2149.2011.00019.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2011] [Indexed: 12/19/2022]
Abstract
This experiment investigated the impact of brief training in acceptance versus distraction-based pain management on experimental pain tolerance in conditions of lower and higher potential threats. One hundred fifty-one pain-free Chinese adults (93 women, 58 men) randomly assigned to acceptance, distraction or pain education control conditions engaged in a cold pressor test (CPT) after reading validated orienting information designed to prime either the safety of the CPT (lower threat) or symptoms and damaging effects of exposure to extreme cold (higher threat). A 2 (threat level) × 3 (training strategy) analysis of covariance, controlling for pre-intervention pain tolerance and education, indicated the acceptance group was more pain tolerant than other training groups. This main effect was qualified by an interaction with threat level: in the lower threat condition, acceptance group participants were more pain tolerant than peers in the distraction or pain education groups while no training group differences were found in the higher threat condition. Supplementary analyses identified catastrophizing as a partial mediator of training group differences in pain tolerance. In summary, findings suggested acceptance-based coping is superior to distraction as a means of managing experimental pain, particularly when pain sensations are viewed as comparatively low in potential threat.
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Affiliation(s)
- T Jackson
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China.
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Fontani V, Rinaldi S, Aravagli L, Mannu P, Castagna A, Margotti ML. Noninvasive radioelectric asymmetric brain stimulation in the treatment of stress-related pain and physical problems: psychometric evaluation in a randomized, single-blind placebo-controlled, naturalistic study. Int J Gen Med 2011; 4:681-6. [PMID: 22069368 PMCID: PMC3206109 DOI: 10.2147/ijgm.s24628] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to investigate the effects of noninvasive radioelectric asymmetric conveyer brain stimulation (REAC-BS) on pain and physical problems, a measurement cluster of the Psychological Stress Measure (PSM) test. When the symptoms of pain and physical problems do not respond to various therapeutic approaches such as medication, physiotherapy, and psychotherapy, they are often called medically unexplained symptoms. As such, these symptoms are reported to be a response to stressful situations or emotional states, often unknown to patients themselves. To explore the effectiveness of noninvasive radioelectric brain stimulation in the amelioration of symptoms of pain and physical problems, we administered a neuropsychophysical optimization protocol using a REAC device. Methods The PSM, a self-administered questionnaire, was used to measure psychological stress and pain and physical problems in a group of 888 subjects. Data were collected immediately prior to and following a 4-week REAC treatment cycle. Results There was a significant reduction in scores measuring subjective perceptions of stress for subjects treated with one cycle of neuropsychophysical optimization REAC-BS. At the end of the study, the number of treated subjects reporting symptoms of stress-related pain and physical problems on the PSM test was significantly reduced, whereas there was no difference in placebo-treated subjects. Conclusion One cycle of neuropsychophysical optimization REAC-BS appears to reduce subjective perceptions of stress as measured by the PSM, particularly on the pain and physical problems cluster.
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Affiliation(s)
- Vania Fontani
- Rinaldi-Fontani Institute, University of Florence, Florence, Italy
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Moix J, Kovacs FM, Martín A, Plana MN, Royuela A. Catastrophizing, State Anxiety, Anger, and Depressive Symptoms Do Not Correlate with Disability when Variations of Trait Anxiety Are Taken into Account. A Study of Chronic Low Back Pain Patients Treated in Spanish Pain Units [NCT00360802]. PAIN MEDICINE 2011; 12:1008-17. [DOI: 10.1111/j.1526-4637.2011.01155.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mendelek F, Kheir RB, Caby I, Thevenon A, Pelayo P. On the quantitative relationships between individual/occupational risk factors and low back pain prevalence using nonparametric approaches. Joint Bone Spine 2011; 78:619-24. [PMID: 21549633 DOI: 10.1016/j.jbspin.2011.01.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 01/26/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore dual quantitative relationships between low back pain (LBP) prevalence and different individual and occupational risk factors, and detect the most important ones which can be used as weighted input data in LBP prediction diagnosis models, providing effective tools to help with the implementation of protection and prevention strategies among hospital staff. METHODS Fourteen predictor individual risk factors (e.g., age, gender, body mass index BMI [kg/m(2)], domestic activity, etc.) and 17 occupational risk factors (e.g., job status, standing hours/day, sufficient break time, job dissatisfaction, etc.) were collected using self-reported questionnaire among the staff of Sacré-Coeur hospital - Lebanon (used as a case study), and correlated with LBP prevalence using Kendall's tau-b bivariate nonparametric approaches. RESULTS This study indicates that among the investigated occupational risk factors, job status, working hours/day, and standing hours/day are the most influencing on LBP prevalence (highly correlated with other factors at 1 and 5% confidence levels). It also shows that strong positive (between 0.25 and 0.65)/negative (from -0.38 to -0.26) statistical correlations to LBP prevalence exist between these risk occupational factors and working days/week, sitting hours/day, job stress, job dissatisfaction, children care, and car driving. The weekly hours of domestic activity, the staff height, and gender type have proven also to be the strongest individual factors in aggravating LBP disease. These individual factors are highly correlated at 1% significance level (ranging between 0.28 and 0.49 for positive correlations, and from -0.49 to -0.25 for negative ones) to children care, weight, extra professional activity, and use of handling techniques. CONCLUSIONS These obtained bivariate correlations can be used successfully by expert physicians in their decision making for LBP diagnosis.
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Affiliation(s)
- Fady Mendelek
- Sacré-Cœur Hospital, Physiotherapy Service, Baabda, Lebanon.
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Fear-avoidance and Endurance-related Responses to Pain: New Models of Behavior and Their Consequences for Clinical Practice. Clin J Pain 2010; 26:747-53. [DOI: 10.1097/ajp.0b013e3181e104f2] [Citation(s) in RCA: 207] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tveito TH, Shaw WS, Huang YH, Nicholas M, Wagner G. Managing pain in the workplace: a focus group study of challenges, strategies and what matters most to workers with low back pain. Disabil Rehabil 2010; 32:2035-45. [PMID: 20860528 DOI: 10.3109/09638281003797398] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Most working adults with low back pain (LBP) continue to work despite pain, but few studies have assessed self-management strategies in this at-work population. The purpose of this study was to identify workplace challenges and self-management strategies reported by workers remaining at work despite recurrent or persistent LBP, to be used as a framework for the development of a workplace group intervention to prevent back disability. METHOD Workers with LBP (n = 38) participated in five focus groups, and audio recordings of sessions were analysed to assemble lists of common challenges and coping strategies. A separate analysis provided a general categorisation of major themes. RESULTS Workplace pain challenges fell within four domains: activity interference, negative self-perceptions, interpersonal challenges and inflexibility of work. Self-management strategies consisted of modifying work activities and routines, reducing pain symptoms, using cognitive strategies and communicating pain effectively. Theme extraction identified six predominant themes: knowing your work setting, talking about pain, being prepared for a bad day, thoughts and emotions, keeping moving and finding leeway. CONCLUSIONS To retain workers with LBP, this qualitative investigation suggests future intervention efforts should focus on worker communication and cognitions related to pain, pacing of work and employer efforts to provide leeway for altered job routines.
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Affiliation(s)
- Torill Helene Tveito
- Harvard School of Public Health, Environmental Health, Boston, Massachusetts 02115, USA.
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Validation of an adaptation of the stress process model for predicting low back pain related long-term disability outcomes: a cohort study. Spine (Phila Pa 1976) 2010; 35:1307-15. [PMID: 20461038 DOI: 10.1097/brs.0b013e3181c03d06] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Twelve-month cohort study. OBJECTIVE The aim of the study was to examine the ability of an adaptation of the stress process model to predict different outcomes among low back pain (LBP) sufferers. SUMMARY OF BACKGROUND DATA Recently, the stress process model was adapted and was shown to be useful to partially explain long-term disability related to low back pain, an important occupational health problem. METHODS French-speaking compensated workers on sick leave because of subacute common LBP (N=439) completed a questionnaire including the adapted stress process model's factors: life events and appraisal, cognitive appraisal of LBP, emotional distress, avoidance coping strategies, and functional disability. Six and 12 months later, participants gave information about their work status, number of days of absence, and functional disability. Regression analyses were performed to identify significant predictive factors of these outcomes. Pain intensity, fear of work, gender, and presence of pain radiating below the knee were used as control variables. RESULTS Number of days of absence, functional disability, and absence from work were predicted at 6 and 12 months by cognitive appraisal of LBP and emotional distress. Functional disability was predicted in addition by functional disability at study entry (T1). When the control variables were considered, number of days of absence was predicted at 6 months by cognitive appraisal, fear of work, and being a male, and, in addition, by emotional distress at 12 months. Functional disability was predicted by functional disability t1, emotional distress, cognitive appraisal of LBP, and fear of work at 6 months, and by the same factors and variables at 12 months, except for functional disability t1. Regarding absence from work, it was predicted at 6 months by fear of work and being a male, and at 12 months by cognitive appraisal of LBP and fear of work. CONCLUSION In association with fear of work, 2 factors from the adapted stress process model are significantly useful for predicting LBP related long-term disability outcomes and could be targeted by preventive interventions.
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Ferris GR, Rogers LM, Blass FR, Hochwarter WA. Interaction of job‐limiting pain and political skill on job satisfaction and organizational citizenship behavior. JOURNAL OF MANAGERIAL PSYCHOLOGY 2009. [DOI: 10.1108/02683940910989002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
BACKGROUND AND PURPOSE Methods for identification of patients with illness behavior in orthopedic settings are still being debated. The purpose of this study was to test the association between illness behavior, depressed mood, pain intensity, self-rated disability, and clinical status in patients with chronic musculoskeletal pain (CMP). METHODS We examined 174 consecutive sick-listed patients (90 women). Musculoskeletal function was estimated by range of motion, muscle strength, and motor and sensory function. The degree of illness behavior was measured by Waddell signs (WS), RESULTS: WS were observed in 47/174 (27%) of the patients, 16% of whom manifested excessive illness behaviour. In general, more patients with WS were depressed (OR = 4.4; 95% CI: 1.8-11) and experienced greater pain (OR = 2.9; CI: 1.1-7.7). No abnormal physical function could be observed in two-thirds of the patients. Other predictive factors for manifesting WS at the clinical examinations were longer sick leave and previous full sick leave (p < 0.05). INTERPRETATION Excessive illness behavior is related to psychological distress in patients with CMP and long-term disability. Thus, some patients may also require psychological assessment. Looking for WS during consultation is useful for targeting other factors that may be important in the diagnostic process.
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Affiliation(s)
- Patricia Olaya-Contreras
- Department of Orthopedics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Sweden.
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Effects of threatening information on interpersonal responses to pain. Eur J Pain 2008; 13:431-8. [PMID: 18602319 DOI: 10.1016/j.ejpain.2008.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2008] [Revised: 05/04/2008] [Accepted: 05/21/2008] [Indexed: 11/20/2022]
Abstract
Emerging evidence indicates that meanings attributed to pain contribute to tolerance and coping among affected individuals. However, links between pain appraisals and coping responses have received little attention within a broader interpersonal context. In this experiment, effects of appraisal on pain tolerance and coping were examined in adult dyads. Eighty-six acquaintance/friend pairs were randomly assigned to the role of Participant in a cold pressor test (CPT) or observer-helper who assisted in coping. Before the task, pairs in the threat condition read about frostbite symptoms and consequences, while those in the reassurance condition read about the safety of the task. In a mixed condition, Participants and Observers read the reassurance and threat passage, respectively. Between-groups analyses revealed threat group participants had lower pain tolerance and reported less cognitive coping than did participants in other appraisal conditions. Threat group observers reported less attention diversion, coping self-statements and ignoring in helping their partner than did reassured observers. Pain language was also most prominent in transactions of threatened dyads. Finally, use of attention diversion by observers contributed to pain tolerance, independent of participant factors (reported pain, appraisal condition, reported coping) and pain language in conversations during immersions. The study highlights how appraisal contributes not only to pain tolerance and coping in the affected individual but also to care-giving efforts of others in their social environment.
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