Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Department of Rehabilitation Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Pain Med. 2021 Dec 11;22(12):2974-2989. doi: 10.1093/pm/pnaa430.
This systematic review and meta-analysis examined relationships between low back pain (LBP)-related disability and pain beliefs, including pain catastrophizing, pain-related fear, self-efficacy, and back pain beliefs, in non-English-speaking populations. Additionally, the effects of selected cultural factors (i.e., language/geographic area) on the strength of relationships were examined.
Systematic review and meta-analysis.
Nine databases were searched. Studies included observational or randomized control clinical trials. Eligible studies had to report estimates of the association between pain beliefs and disability. Pooled estimates of correlation coefficients were obtained through random-effects meta-analysis methods.
Fifty-nine studies, (n = 15,383) were included. Moderate correlations were identified between disability and pain self-efficacy (chronic LBP r = -0.51, P ≤ 0.001), between disability and pain catastrophizing (acute LBP r = 0.47, P ≤ 0.001; chronic LBP r = 0.44, P ≤ 0.001), and also between disability and pain-related fear (chronic LBP r = 0.41, P ≤ 0.001). Otherwise, weak correlations were identified between disability and most pain beliefs (range r = -0.23 to 0.35, P ≤ 0.001). Pooled correlation coefficients between disability and all pain beliefs (except the Fear Avoidance Belief Questionnaire-Work subscale) represent medium effects and suggest that lower disability was associated with greater pain self-efficacy, less pain-related fear, less catastrophic thinking, and less negative back pain beliefs about the nature and cause of back pain. Results were consistent across most language groups and geographic regions; few studies reported ethnicity or religion.
LBP-related disability was associated with pain-related beliefs, with consistency demonstrated for each pain belief construct across divergent non-English-speaking populations. Further research examining cultural factors, such as ethnicity or religion, and with a more diverse population is warranted.
本系统评价和荟萃分析检查了非英语人群中腰痛（LBP）相关残疾与疼痛信念（包括疼痛灾难化、疼痛相关恐惧、自我效能和腰痛信念）之间的关系。此外，还检查了选定的文化因素（即语言/地理区域）对关系强度的影响。
系统评价和荟萃分析。
检索了 9 个数据库。研究包括观察性或随机对照临床试验。合格的研究必须报告疼痛信念与残疾之间的关联估计值。通过随机效应荟萃分析方法获得了汇总估计的相关系数。
纳入了 59 项研究（n=15383）。确定了残疾与疼痛自我效能（慢性 LBP r=-0.51，P≤0.001）、残疾与疼痛灾难化（急性 LBP r=0.47，P≤0.001；慢性 LBP r=0.44，P≤0.001）以及残疾与疼痛相关恐惧（慢性 LBP r=0.41，P≤0.001）之间存在中度相关性。否则，残疾与大多数疼痛信念（范围 r=-0.23 至 0.35，P≤0.001）之间存在弱相关性。残疾与所有疼痛信念（恐惧回避信念问卷工作分量表除外）之间的汇总相关系数代表中等效应，表明较低的残疾与更高的疼痛自我效能、更少的疼痛相关恐惧、更少的灾难性思维以及对疼痛性质和原因的更积极的腰痛信念相关。结果在大多数语言群体和地理区域中是一致的；很少有研究报告了种族或宗教。
LBP 相关残疾与疼痛相关信念相关，每种疼痛信念结构在不同的非英语人群中均表现出一致性。需要进一步研究文化因素，如种族或宗教，以及更具多样性的人群。
