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腰痛咨询相关因素的社区调查

Community survey of factors associated with consultation for low back pain.

作者信息

Waxman R, Tennant A, Helliwell P

机构信息

Rheumatology and Rehabilitation Research Unit, University of Leeds Research School of Medicine, Leeds, UK.

出版信息

BMJ. 1998 Dec 5;317(7172):1564-7. doi: 10.1136/bmj.317.7172.1564.

Abstract

OBJECTIVE

To investigate the psychosocial factors associated with consultation for low back pain.

DESIGN

Two phase cross sectional postal survey.

SETTING

Bradford Metropolitan Health District.

SUBJECTS

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.

MAIN OUTCOME MEASURES

Six psychosocial constructs.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

调查与腰痛咨询相关的社会心理因素。

设计

两阶段横断面邮寄调查。

地点

布拉德福德都会区卫生区。

研究对象

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。

主要观察指标

六种社会心理结构。

结果

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)。

结论

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。

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