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心理社会工作特征与腰痛结局的关联

Association of psychosocial work characteristics with low back pain outcomes.

作者信息

Mielenz Thelma J, Garrett Joanne M, Carey Timothy S

机构信息

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC 27599-7280, USA.

出版信息

Spine (Phila Pa 1976). 2008 May 15;33(11):1270-5. doi: 10.1097/BRS.0b013e31817144c3.

Abstract

STUDY DESIGN

This is a secondary analysis of a prospective cohort of 295 patients with acute low back pain presenting to 31 primary care physicians in North Carolina.

OBJECTIVE

This study examines the hypothesis that dissatisfaction with job tasks and lack of social support from coworkers and supervisor are associated with poorer low back pain outcomes.

SUMMARY OF BACKGROUND DATA

Psychosocial work characteristics are thought to be associated with the occurrence, report, and development of long-term disability from low back pain, but the studies are inconclusive. METHOD.: Three psychosocial work characteristics were separately compared to these outcomes: time to functional recovery, attainment of complete recovery, and clinically relevant change on the Modified Roland Scale.

RESULTS

Relative to subjects with more social support from coworkers, subjects with less social support from coworkers have 1.55 (95% CI = 1.04-2.34) times the risk of not attaining complete recovery from low back pain at 8 weeks. For all other outcomes evaluated in this study, there was not an association with the psychosocial work characteristics. Biomechanical demands were found not to modify this association.

CONCLUSION

This analysis provides evidence that social support in the workplace from coworkers but not social support from a supervisor or job task satisfaction are likely targets for intervention.

摘要

研究设计

这是一项对295例急性腰痛患者的前瞻性队列研究的二次分析,这些患者就诊于北卡罗来纳州的31名初级保健医生。

目的

本研究检验以下假设,即对工作任务的不满以及同事和上级缺乏社会支持与较差的腰痛结局相关。

背景数据总结

心理社会工作特征被认为与腰痛导致的长期残疾的发生、报告及发展相关,但研究结果尚无定论。方法:将三种心理社会工作特征分别与以下结局进行比较:功能恢复时间、完全恢复情况以及改良罗兰量表上的临床相关变化。

结果

与从同事那里获得更多社会支持的受试者相比,从同事那里获得较少社会支持的受试者在8周时未从腰痛中完全恢复的风险是前者的1.55倍(95%可信区间=1.04-2.34)。对于本研究评估的所有其他结局,均未发现与心理社会工作特征存在关联。发现生物力学需求并未改变这种关联。

结论

该分析提供了证据,表明工作场所中同事给予的社会支持而非上级给予的社会支持或工作任务满意度可能是干预的目标。

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