Byrns George, Agnew Jacqueline, Curbow Barbara
Department of Health Sciences, Illinois State University, Normal, Illinois, USA.
Appl Occup Environ Hyg. 2002 Nov;17(11):752-64. doi: 10.1080/10473220290096050.
Occupational low back pain (LBP) is a major cause of morbidity and cost. Efforts to control LBP are largely unsuccessful, and better understanding of risks is needed, especially psychological factors. The purpose of this research was to assess the association between worker attributions and LBP. Attributing LBP to internal causes may increase the worker's perceived control, whereas external attribution may cause distress. A new model was developed to explore these associations. A cross-sectional design was used in this study of 278 garment workers. Data were gathered by a self-administered questionnaire and through direct observation. Responses to questions on worker attributions of LBP cause and knowledge of back safety were subjected to factor analysis and other psychometric evaluation to develop scales. Six hypotheses were tested using multivariate logistic regression. Workers who scored high in internal attribution were more likely to be knowledgeable of back safety (OR = 3.7, 95% CI = 2.0-6.7). Workers reporting high demand were more likely to report LBP (OR = 2.3, 95% CI = 1.2-4.4). Workers attributing LBP to job tasks were more likely to report LBP (OR = 3.2, 95% CI = 1.5-6.9), and those reporting high supervisor support were less likely to report LBP (OR = 0.23, 95% CI = 0.08-0.66). Workers with annual incomes above 15,000 dollars were more likely to report LBP in the test of both the Demand-Control-Support and Attribution models (OR = 2.8, 95% CI = 1.2-6.9 and OR = 4.1, 95% CI = 1.5-11.1, respectively). While both models appeared to be useful for the study of low back pain, the R(2)(L) of the Demand-Control-Support model equaled only 11.9 percent, whereas the Attribution model equaled 26.2 percent. This study provides evidence that attribution theory is useful in the study of LBP, including in future interventions in the prevention of LBP.
职业性腰痛是发病和成本的主要原因。控制腰痛的努力大多未成功，需要更好地了解风险，尤其是心理因素。本研究的目的是评估工人归因与腰痛之间的关联。将腰痛归因于内部原因可能会增加工人的感知控制感，而外部归因可能会导致痛苦。开发了一个新模型来探索这些关联。本研究对278名服装工人采用横断面设计。数据通过自填问卷和直接观察收集。对关于工人对腰痛原因的归因和背部安全知识的问题的回答进行了因子分析和其他心理测量评估以制定量表。使用多变量逻辑回归检验了六个假设。内部归因得分高的工人更有可能了解背部安全知识（比值比=3.7，95%置信区间=2.0-6.7）。报告高需求的工人更有可能报告腰痛（比值比=2.3，95%置信区间=1.2-4.4）。将腰痛归因于工作任务的工人更有可能报告腰痛（比值比=3.2，95%置信区间=1.5-6.9），而报告主管支持度高的工人报告腰痛的可能性较小（比值比=0.23，95%置信区间=0.08-0.66）。在需求-控制-支持模型和归因模型的测试中，年收入超过15000美元的工人更有可能报告腰痛（分别为比值比=2.8，95%置信区间=1.2-6.9和比值比=4.1，95%置信区间=1.5-11.1）。虽然这两个模型似乎都有助于腰痛的研究，但需求-控制-支持模型的R(2)(L)仅为11.9%，而归因模型为26.2%。本研究提供了证据表明归因理论在腰痛研究中有用，包括在未来预防腰痛的干预措施中。
