School of Health Sciences, The University of Notre Dame Australia, 19 Mouat St, Fremantle, WA 6959, Australia.
Eur Spine J. 2010 Apr;19(4):633-40. doi: 10.1007/s00586-009-1180-9. Epub 2009 Oct 23.
For an individual, the functional consequences of an episode of low back pain is a key measure of their clinical status. Self-reported disability measures are commonly used to capture this component of the back pain experience. In non-acute low back pain there is some uncertainty of the validity of this approach. It appears that self-reported assessment of disability and direct measurements of functional status are only moderately related. In this cross-sectional study, we investigated this relationship in a sample of 94 acute low back pain patients. Both self-reported disability and a performance-based assessment of disability were assessed, along with extensive profiling of patient characteristics. Scale consistency of the performance-based assessment was investigated using Cronbach's alpha, the relationship between self-reported and performance-based assessment of disability was investigated using Pearson's correlation. The relationship between clinical profile and each of the disability measures were examined using Pearson's correlations and multivariate linear regression. Our results demonstrate that the battery of tests used are internally reliable (Cronbach's alpha = 0.86). We found only moderate correlations between the two disability measures (r = 0.471, p < 0.001). Self-reported disability was significantly correlated with symptom distribution, medication use, physical well-being, pain intensity, depression, somatic distress and anxiety. The only significant correlations with the performance-based measure were symptom distribution, physical well-being and pain intensity. In the multivariate analyses no psychological measure made a significant unique contribution to the prediction of the performance-based measure, whereas depression made a unique contribution to the prediction of the self-reported measure. Our results suggest that self-reported and performance-based assessments of disability are influenced by different patient characteristics. In particular, it appears self-reported measures of disability are more influenced by the patient's psychological status than performance-based measures of disability.
对于个体来说，腰痛发作的功能后果是其临床状况的关键衡量标准。自我报告的残疾测量通常用于捕捉腰痛体验的这一部分。在非急性腰痛中，这种方法的有效性存在一定的不确定性。似乎自我报告的残疾评估和功能状态的直接测量仅具有中度相关性。在这项横断面研究中，我们在 94 名急性腰痛患者的样本中研究了这种关系。评估了自我报告的残疾和基于表现的残疾评估，以及对患者特征的广泛分析。使用 Cronbach 的 alpha 研究了基于表现的评估的量表一致性，使用 Pearson 相关研究了自我报告和基于表现的残疾评估之间的关系。使用 Pearson 相关和多元线性回归研究了临床特征与每种残疾测量之间的关系。我们的结果表明，所使用的测试组合具有内部可靠性（Cronbach 的 alpha = 0.86）。我们发现两种残疾测量之间只有中度相关性（r = 0.471，p <0.001）。自我报告的残疾与症状分布、药物使用、身体状况、疼痛强度、抑郁、躯体不适和焦虑显著相关。与基于表现的测量唯一显著相关的是症状分布、身体状况和疼痛强度。在多元分析中，没有任何心理测量对基于表现的测量的预测有显著的独特贡献，而抑郁对自我报告的测量的预测有独特的贡献。我们的结果表明，自我报告和基于表现的残疾评估受到不同患者特征的影响。特别是，似乎自我报告的残疾测量比基于表现的残疾测量更受患者心理状态的影响。
