Shaw William S, Pransky Glenn, Patterson William, Linton Steven J, Winters Thomas
Liberty Mutual Research Institute for Safety, Center for Disability Research, Hopkinton, Massachusetts 01748, USA.
J Occup Environ Med. 2007 Feb;49(2):185-93. doi: 10.1097/01.jom.0000254205.47334.c3.
To identify subgroups of patients with work-related back pain based on disability risk factors.
Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later.
A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group.
Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.
基于残疾风险因素确定与工作相关的背痛患者亚组。
与工作相关的背痛患者（N = 528）在首次医学评估前完成了一份包含16项潜在残疾风险因素的问卷。在1个月和3个月后评估疼痛、功能受限和工作残疾的结果。
对5个残疾风险因素（疼痛、情绪低落、恐惧回避信念、工作灵活性差和对恢复的期望低）进行K均值聚类分析，得出4个亚组：低风险组（n = 182）；情绪困扰组（n = 103）；严重疼痛/恐惧回避组（n = 102）；以及对工作调整的担忧组（n = 141）。随访时的疼痛和残疾结果在低风险组中最佳，在严重疼痛/恐惧回避组中最差。
急性背痛患者可根据残疾是否与疼痛信念、情绪困扰或工作场所担忧相关分为不同亚组。
