PSYCHOSOCIAL PREDICTORS OF OUTCOME IN ACUTE AND SUBCHRONIC LOW-BACK TROUBLE
PSYCHOSOCIAL PREDICTORS OF OUTCOME IN ACUTE AND SUBCHRONIC LOW-BACK TROUBLE
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DOI：
10.1097/00007632-199503150-00014
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发表时间：
1995-03-15
期刊：
影响因子：
3
通讯作者：
HOLLIS, S
中科院分区：
文献类型：
--
作者：
BURTON, AK;TILLOTSON, KM;HOLLIS, S
研究设计.一项对因腰痛寻求初级保健的患者的前瞻性调查。临床和心理社会学数据，在介绍，探讨预测结果的1年。目的。确定临床和心理社会变量对早期识别预后不良患者的相对价值。背景资料概要。目前的腰痛治疗策略未能阻止残疾水平的上升。心理社会因素已被证明是慢性患者对治疗反应的重要决定因素，但急性或亚慢性患者的类似数据的贡献尚未得到全面调查。252例腰痛患者，提出初级保健，进行了结构化的临床访谈，并完成了电池的心理社会工具。在1年时通过邮件进行随访;使用背痛残疾问卷测量结果。在就诊时的数据和随访时的残疾之间寻找预测关系。大多数患者的残疾和疼痛评分有所改善，但超过一半的患者症状持续存在。18%的人在介绍时表现出明显的心理困扰。多元回归分析表明，持续残疾的水平主要取决于社会心理领域的措施，急性病例的结果也取决于以前的历史的存在或不存在的下背部麻烦。判别模型成功地分配典型的76%的情况下，恢复/未恢复组，主要是在心理社会因素的基础上，在presentation. Conclusions。早期识别心理社会问题是重要的，在理解，并希望防止，进展到慢性腰痛麻烦。
Study Design. A prospective survey of patients seeking primary care for low back pain. Clinical and psychosocial data, available at presentation, were explored for predictors of outcome at 1 year.Objectives. To determine the relative value of clinical and psychosocial variables for early identification of patients with a poor prognosis.Summary of Background Data. Current treatment strategies for low back pain have failed to stem the rising levels of disability. Psychosocial factors have been shown to be important determinants of response to therapy in chronic patients, but the contribution from similar data in acute or subchronic patients has not been comprehensively investigated.Methods. Two hundred fifty-two patients with low back pain, presenting to primary care, underwent a structured clinical interview and completed a battery of psychosocial instruments. Follow-up was done by mail at 1 year; outcome was measured using a back pain disability questionnaire. Predictive relationships were sought between the data at presentation and disability at follow-up.Results. Most patients showed improved disability and pain scores, although more than half had persisting symptoms. Eighteen percent showed significant psychological distress at presentation. Multiple regression analysis showed the level of persisting disability to depend principally on measures in the psychosocial domain; for acute cases outcome is also dependent on the absence or presence of a previous history of low back trouble. Discriminant models successfully allocated typically 76% of cases to recovered/not-recovered groups, largely on the basis of psychosocial factors evident at presentation.Conclusions. Early identification of psychosocial problems is important in understanding, and hopefully preventing, the progression to chronicity in low back trouble.