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Pain belief screening instrument: development and preliminary validation of a screening instrument for disabling persistent pain
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Caring Sciences)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Caring Sciences)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Caring Sciences)
2007 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 6, 461-466 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To develop and test the ability of a screening instrument to identify subgroups among primary healthcare patients with musculoskeletal pain. The Pain Belief Screening Instrument covers pain intensity, disability, self-efficacy, fear avoidance and catastrophizing. DESIGN: Cross-sectional, correlational and comparative study. SUBJECTS: Patients in primary healthcare (n1 = 215; n2 = 93) with a pain duration of 4 weeks or more were included. METHODS: Items for the Pain Belief Screening Instrument were derived from principal component analyses of: the Self-efficacy Scale, the Tampa Scale of Kinesiophobia and the Catastrophizing subscale in the Coping Strategies Questionnaire. Cluster solutions of scores on the screening instrument and the original instruments were cross-tabulated. The reliability of items in the Pain Belief Screening Instrument was examined. RESULTS: The screening instrument identified 2 groups: high- or low-risk profile for pain-related disability. Validity was in-between moderate and substantial (kappa = 0.61, p < 0.001). The reliability of each item in the Pain Belief Screening Instrument in relation to the corresponding item in the original instruments was moderate to high (rs 0.50-0.80, p < 0.01). CONCLUSION: The screening instrument fairly well replicated subgroups identified by the original instruments. The reliability of items in the screening instrument was acceptable. Further testing of predictive validity for a primary healthcare population is needed.

Place, publisher, year, edition, pages
2007. Vol. 39, no 6, 461-466 p.
Keyword [en]
musculoskeletal pain, primary healthcare, self-efficacy, fear avoidance
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97107DOI: 10.2340/16501977-0072ISI: 000248226400005PubMedID: 17624480OAI: oai:DiVA.org:uu-97107DiVA: diva2:171903
Available from: 2008-04-25 Created: 2008-04-25 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Screening, Targeting, Tailoring, and Implementation in Primary Health Care: An integrated physical therapy and behavioural medicine approach to persons with persistent musculoskeletal pain
Open this publication in new window or tab >>Screening, Targeting, Tailoring, and Implementation in Primary Health Care: An integrated physical therapy and behavioural medicine approach to persons with persistent musculoskeletal pain
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis deals with a behavioural medicine approach to the management of patients with persistent musculoskeletal pain in primary health care physical therapy. The main aims of the thesis were; to develop, and evaluate the psychometric properties of, a screening instrument for risk of disability and; to evaluate the implementation and effects of a targeted and tailored treatment.

The studies comprise four samples of patients with musculoskeletal pain exceeding one month. All subjects were recruited when consulting physical therapists in Swedish primary health care settings. For development and evaluation of the Pain Belief Screening Instrument (PBSI) four samples were used; two samples (n1 = 215 and n2 = 93) in Study I, one sample (n = 168) in Study II, and one sample (n = 45) in Study III. For evaluation of implementation and effects of targeted and tailored treatment the 32 patients who completed treatment in Study III were used. In Study IV treatment documents of 18 patient cases from Study III were studied to evaluate treatment integrity.

The concurrent and predictive validity of the PBSI was good, and the instrument was therefore used to define subgroups with either a high or low risk for disability. A low treatment dosage of a tailored treatment for low risk patients was tried and found equally efficient as a longer treatment focusing physical exercise. Subjects who received a treatment tailored to individual patient characteristics perceived a better global outcome of treatment compared to subjects in the control group. However, no between-group differences in the disability measures were found. The evaluation of treatment integrity displayed low therapist adherence to the treatment rationale for the tailored treatment.

The studies demonstrate ways to systematically integrate a behavioural medicine approach and physical therapy. The results indicate efficiency in managing patients with persistent musculoskeletal pain in primary health care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 67 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 338
Keyword
Caring sciences, physical therapy, behavioural medicine, screening, chronic pain, primary health care, Vårdvetenskap
Identifiers
urn:nbn:se:uu:diva-8665 (URN)978-91-554-7174-3 (ISBN)
Public defence
2008-05-16, Sal IX, Universitetshuset, Övre Slottsgatan 2, Uppsala, 13:00
Opponent
Supervisors
Available from: 2008-04-25 Created: 2008-04-25Bibliographically approved

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