Alotaibi Mazyad A, Alhowimel Ahmed S, Alodaibi Faris A, Alimam Dalia, Alghadier Mshari, Elnaggar Ragab K
Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia.
Medicine (Baltimore). 2025 Jul 25;104(30):e43510. doi: 10.1097/MD.0000000000043510.
Fear-avoidance beliefs are recognized globally as psychological factors contributing to chronic low back pain (CLBP), influencing pain perception and disability. While this relationship has been explored across various populations, there is limited evidence in Asian countries, including Saudi Arabia. Understanding regional variations is essential for developing culturally sensitive interventions. This study analyzes the relationship between fear-avoidance beliefs with pain and disability in Saudi Arabian patients with CLBP and analyze potential differences between subgroups according to the time of evolution. A cross-sectional study was conducted among 178 patients aged 18 to 65 years diagnosed with CLBP. Sociodemographic data, pain intensity, disability (Roland Morris Questionnaire), and fear-avoidance beliefs questionnaire were collected. Participants had a mean age of 42.3 ± 11.6 years; 50% were male, for the disability model, the significant predictors were interference, fear-avoidance beliefs questionnaire-physical activity, and occupation. The significant predictors for the pain intensity model were interference, age, and duration. The R2 for the disability model was 0.33, indicating that the included variables can explain 33% of the variance in disability, while the R2 for the pain intensity model was 0.50, indicating that the included variables can explain 50% of the variance in pain intensity. Fear-avoidance beliefs and pain interference significantly contribute to disability and pain in Saudi CLBP patients. Although age was a contributing factor, the wide age range may limit generalizability. These findings, however, emphasize the need for pain interference and fear-avoidance interventions in patients with CLBP to reduce disability and improve outcomes.
恐惧回避信念在全球范围内被公认为是导致慢性下腰痛（CLBP）的心理因素，会影响疼痛感知和残疾状况。虽然这种关系已在不同人群中进行了探讨，但在包括沙特阿拉伯在内的亚洲国家，相关证据有限。了解区域差异对于制定具有文化敏感性的干预措施至关重要。本研究分析了沙特阿拉伯CLBP患者中恐惧回避信念与疼痛和残疾之间的关系，并根据病程分析了亚组之间的潜在差异。对178例年龄在18至65岁之间被诊断为CLBP的患者进行了横断面研究。收集了社会人口统计学数据、疼痛强度、残疾情况（罗兰·莫里斯问卷）和恐惧回避信念问卷。参与者的平均年龄为42.3±11.6岁；50%为男性，对于残疾模型，显著预测因素为干扰、恐惧回避信念问卷-身体活动和职业。疼痛强度模型的显著预测因素为干扰、年龄和病程。残疾模型的R2为0.33，表明纳入的变量可解释残疾差异的33%，而疼痛强度模型的R2为0.50，表明纳入的变量可解释疼痛强度差异的50%。恐惧回避信念和疼痛干扰在沙特CLBP患者的残疾和疼痛中起显著作用。虽然年龄是一个因素，但较宽的年龄范围可能会限制研究结果的普遍性。然而，这些发现强调了对CLBP患者进行疼痛干扰和恐惧回避干预以减少残疾并改善治疗效果的必要性。
