Moffett J A Klaber, Underwood M R, Gardiner E D
Institute of Rehabilitation, Post Graduate Medical Institute, University of Hull, Hull, UK.
Disabil Rehabil. 2009;31(10):783-90. doi: 10.1080/09638280802309327.
To investigate whether socioeconomic status in patients with back pain participating in a randomised controlled trial was predictive of functional disability (Roland Disability Questionnaire, RDQ).
Secondary analysis of data (n = 949) from a national primary care trial of physical treatments for back pain (UKBEAM trial) using multilevel modelling. The three indicators were Townsend scores, educational levels and work status.
All indicators were significant predictors of outcome after adjusting for baseline variables. As Townsend scores increased (indicating greater deprivation) RDQ scores (functional disability related to back pain) increased. Lower levels of educational attainment were associated with higher RDQ scores. Those 'Not in Work' reported markedly higher levels of RDQ scores which increased over time. There was no evidence that one particular treatment was more suitable for participants of different socioeconomic status.
The findings from this study add to the body of literature which suggests the importance of socioeconomic factors as an influence on health, including resultant disability related to chronic musculoskeletal conditions such as back pain. Work status was particularly dominant in our findings and may suggest that helping patients with back pain back to work where appropriate, is an especially important part of the management process.
调查参与一项随机对照试验的背痛患者的社会经济状况是否可预测功能障碍（罗兰残疾问卷，RDQ）。
使用多水平模型对一项全国性背痛物理治疗初级保健试验（英国背部疼痛评估试验）的数据（n = 949）进行二次分析。三个指标为汤森得分、教育水平和工作状态。
在对基线变量进行调整后，所有指标均为结果的显著预测因素。随着汤森得分增加（表明贫困程度加剧），RDQ得分（与背痛相关的功能障碍）增加。较低的教育程度与较高的RDQ得分相关。那些“未工作”的人报告的RDQ得分明显更高，且随时间增加。没有证据表明一种特定治疗方法对不同社会经济状况的参与者更合适。
本研究结果补充了相关文献，表明社会经济因素作为影响健康的因素的重要性，包括与慢性肌肉骨骼疾病如背痛相关的残疾。在我们的研究结果中，工作状态尤为突出，这可能表明在适当情况下帮助背痛患者重返工作岗位是管理过程中特别重要的一部分。
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