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The associations between pain intensity, psychosocial variables, and pain duration/recurrence in a large sample of persons with nonspecific spinal pain
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Beteendemedicin och sjukgymnastik, Behavioural medicine and physiotherapy)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Beteendemedicin och sjukgymnastik, Behavioural medicine and physiotherapy)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Beteendemedicin och sjukgymnastik, Behavioural medicine and physiotherapy)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Beteendemedicin och sjukgymnastik, Behavioural medicine and physiotherapy)
2008 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 24, no 7, 611-619 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The aims of this study were: (1) to describe and compare pain intensity, disability, cognitive, physical, behavioral, and environmental variables in 4 predefined categories, on the basis of duration and recurrence of nonspecific spinal pain; and (2) to compare disability, cognitive, physical, behavioral, and environmental variables in these 4 predefined categories, after controlling for pain intensity.

Methods: Postal questionnaires were sent to a random sample of 5000 persons, aged 20 to 50 years, in Sweden. The response rate was 39%. One thousand and twenty-four participants reporting spinal pain were divided into 4 predefined categories (n=100, 215, 172, and 537) based on duration and recurrence of pain. Multivariate analyses of variance and covariance were performed to investigate differences between the 4 pain duration/recurrence groups.

Results: The first analyses revealed that the 4 pain duration/recurrence groups differed in pain intensity, disability, 7 cognitive variables, and perceived social support. After controlling for pain intensity, small but significant group differences were identified in depression, catastrophizing, pain expectations, and perceived social support. Higher levels of catastrophizing and pain expectations and lower levels of perceived social support were seen in groups with longer duration of pain.

Discussion: After controlling for pain intensity, categories based on pain duration/recurrence differed in 3 cognitive variables and perceived social support. Pain expectations, catastrophizing and perceived social support were related to longer duration of pain. Between-group differences were small and pain duration/recurrence was not an important explanatory factor.

Place, publisher, year, edition, pages
2008. Vol. 24, no 7, 611-619 p.
Keyword [en]
musculoskeletal pain, cognitive-behavioral, biopsychosocial, pain intensity, pain duration, general population
National Category
Medical and Health Sciences
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-98831DOI: 10.1097/AJP.0b013e3181726248ISI: 000259662200008PubMedID: 18716500OAI: oai:DiVA.org:uu-98831DiVA: diva2:201279
Available from: 2010-02-18 Created: 2009-03-03 Last updated: 2012-05-21Bibliographically approved
In thesis
1. Behaviours, Beliefs and Back Pain: Prognostic Factors for Disability in the General Population and Implementation of Screening in Primary Care Physiotherapy
Open this publication in new window or tab >>Behaviours, Beliefs and Back Pain: Prognostic Factors for Disability in the General Population and Implementation of Screening in Primary Care Physiotherapy
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to study prognostic factors for prolonged disability in back pain in the general population and physiotherapists’ screening for prolonged disability, applying a social cognitive learning perspective.

Methods and results: Studies I and II were based on a survey in the general population in Sweden. Study I included 1024 individuals aged 20-50 years, reporting non-specific back pain. Four groups (n = 100, 215, 172 and 537) based on duration and recurrence of back pain were formed and compared. After controlling for pain intensity, catastrophising and expectations of future pain were positively correlated to pain duration. Perceived social support was negatively correlated to pain duration. Study II was longitudinal over 12 months and analysed one group reporting first-episode back pain (n = 77), and one group reporting long-term back pain (n = 302). Future pain intensity and disability were predicted by initial levels of pain and disability and pain-related cognitions in both groups. Study III examined the inter-rater reliability of a research protocol for assessment of physiotherapists’ telephone screening for prolonged disability. The results demonstrated sufficient inter-rater reliability. Study IV evaluated the effect of a tailored skills training intervention on physiotherapists’ screening for prolonged disability in back pain. Four physiotherapists in primary care participated in four quasi-experimental single-subject studies. Effects were seen in all participants, with increased screening of prognostic factors and less time spent on detailed discussions about back pain.

Conclusions: The identification of mainly cognitive explanatory variables indicates the relevance of a social cognitive perspective of back pain-related disability (studies I and II). Physiotherapists’ telephone screening for prolonged disability in back can be reliably assessed (study III). It is suggested that interventions based on social cognitive theory are effective in producing change in specified clinical behaviours in physiotherapists (study IV).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 87 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 55
Keyword
Physical therapy, behavioural medicine, back pain, general population, caregiver, prognostic factors, implementation, screening
National Category
Social Sciences
Research subject
Caring Sciences in Social Sciences
Identifiers
urn:nbn:se:uu:diva-121424 (URN)978-91-554-7758-5 (ISBN)
Public defence
2010-05-07, Universitetshuset, sal IX, Övre Slottsgatan 2, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-16 Created: 2010-03-23 Last updated: 2012-05-21Bibliographically approved

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Demmelmaier, IngridLindberg, PerÅsenlöf, PernillaDenison, Eva

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