期刊
PAIN
卷 152, 期 7, 页码 1517-1524出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.pain.2011.02.041
关键词
Fear of movement; Low back pain; Manual handling; Passive coping; Psychosocial factors; Sick leave
资金
- Australian Research Council [LP0562102, SR0566924]
- Australian National Health and Medical Research Council [2005002108]
- New Zealand Health Research Council [456163]
- Queensland Health
- South Australian Department of Health, Injury Prevention and Control Australia (Pty Ltd)
- Nursing Council of New Zealand
- Macquarie Bank Foundation
- Sir Robert Menzies Memorial Foundation Limited
- National Health and Medical Research Council of Australia
- Australian Research Council [SR0566924] Funding Source: Australian Research Council
Sick leave due to low back pain (LBP-SL) is costly and compromises workforce productivity. The fear-avoidance model asserts that maladaptive pain-related cognitions lead to avoidance and disuse, which can perpetuate ongoing pain. Staying home from work is an avoidant behavior, and hence pain-related psychological features may help explain LBP-SL. We examined the relative contribution of pain catastrophizing, fear of movement, and pain coping (active and passive) in LBP-SL in addition to pain characteristics and other psychosocial, occupational, general health, and demographic factors. Two-way interactions between age and gender and candidate exposures were also considered. Our sample comprised 2164 working nurses and midwives with low back pain in the preceding year. Binary logistic regression was performed on cross-sectional data by manual backward stepwise elimination of nonsignificant terms to generate a parsimonious multivariable model. From an extensive array of exposures assessed, fear of movement (women, odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.02-1.08; men, OR = 1.17, 95% CI 1.05-1.29), passive coping (OR = 1.07, 95% CI 1.04-1.11), pain severity (OR = 1.61, 95% CI 1.50-1.72), pain radiation (women, OR = 1.45, 95% CI 1.10-1.92; men, OR = 4.13, 95% CI 2.15-7.95), and manual handling frequency (OR = 1.03, 95% CI 1.01-1.05) increased the likelihood of LBP-SL in the preceding 12 months. Administrators and managers were less likely to report LBP-SL (OR = 0.44, 95% CI 0.27-0.71), and age had a protective effect in individuals in a married or de facto relationship (OR = 0.97, 95% CI 0.95-0.98). In summary, fear of movement, passive coping, frequent manual handling, and severe or radiating pain increase the likelihood of LBP-SL. Gender-specific responses to pain radiation and fear of movement are evident. Crown Copyright (C) 2011 Published by Elsevier B.V. on behalf of International Association for the Study of Pain. All rights reserved.
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