Waxman R, Tennant A, Helliwell P
Rheumatology and Rehabilitation Research Unit, University of Leeds Research School of Medicine, Leeds, UK.
BMJ. 1998 Dec 5;317(7172):1564-7. doi: 10.1136/bmj.317.7172.1564.
To investigate the psychosocial factors associated with consultation for low back pain.
Two phase cross sectional postal survey.
Bradford Metropolitan Health District.
1813 adults responding to the phase 1 questionnaire. 540 of the 782 with an episode of low back pain in the past 12 months completed the second questionnaire.
Six psychosocial constructs.
406 (52%) of the respondents reporting back pain in the past 12 months had not consulted a health professional. Logistic regression showed that consultation was associated with externalised beliefs regarding pain management (odds ratio 3.6; 95% confidence interval 2.1 to 6.0). Duration of pain affected the factors associated with consultation. Consultation for episodes lasting less than two weeks (n=290) was associated with greater than median pain (3.0; 1.7 to 5.5), consultation for episodes over two weeks (n=243) was associated with increased disability (3.7; 1.5 to 9.0), and consultation for episodes over three months (n=143) with increased depression (3.9; 1.3 to 11.8).
The results support a role for psychosocial factors in consultation for low back pain and suggest that the reasons for consultation vary with duration of pain. Duration of the episode may be a useful guide to management of non-specific low back pain.
调查与腰痛咨询相关的社会心理因素。
两阶段横断面邮寄调查。
布拉德福德都会区卫生区。
1813名回复第一阶段问卷的成年人。在过去12个月中有过腰痛发作的782人中,540人完成了第二阶段问卷。
六种社会心理结构。
在过去12个月中报告有背痛的受访者中,406人(52%)未咨询过健康专业人员。逻辑回归显示,咨询与对疼痛管理的外在信念相关(比值比3.6;95%置信区间2.1至6.0)。疼痛持续时间影响与咨询相关的因素。持续时间少于两周的发作(n = 290)的咨询与大于中位数的疼痛相关(3.0;1.7至5.5),持续时间超过两周的发作(n = 243)的咨询与残疾增加相关(3.7;1.5至9.0),持续时间超过三个月的发作(n = 143)的咨询与抑郁增加相关(3.9;1.3至11.8)。
结果支持社会心理因素在腰痛咨询中的作用,并表明咨询原因随疼痛持续时间而变化。发作持续时间可能是管理非特异性腰痛的有用指南。