NEGATIVE BACK BELIEFS ASSOCIATED WITH GENDER, WORK STATUS AND DISABILITY AMONG INDIVIDUALS AT CLINICAL SETTINGS

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Alamrani S1, Alnahdi A2, Alsobayel H3
1University of Tabuk, Physical Therapy, Tabuk, Saudi Arabia, 2King Saud University, Physical Therapy, Riyadh, Saudi Arabia, 3King Saud University, Riyadh, Saudi Arabia

Background: Low back pain remains ranked highest in terms of disability and sixth in terms of overall burden, it is still causing disability more than any other conditions. Treatment guidelines for LBP recommends that health professionals should screen for psychological factors.
Beliefs regarding inevitability of future as a consequence of having back troubles are one of these psychological factors that have recent considerable attention in literature. Although, different studies have investigated back-pain beliefs in populations based level, there is paucity of data about the beliefs of individuals with LPB at a clinical settings.

Purpose: The aim of study was to examine factors that influence back-related beliefs in people with LBP including sociodemographic status, pain profile and disability level.

Methods: 115 individuals with LBP were recruited from Physical Therapy and Orthopedic Clinics at King Khalid University Hospital, Riyadh, Saudi Arabia. Inclusion criteria was Adults, aged between18 and 65 years and with history of LBP. People were excluded if they had low levels of literacy or had any cognitive problems. They completed self-administrated questionnaires along with their demographic information, Arabic Back Beliefs Questionnaire (BBQ- Ar), Arabic Oswestry Disability Index (ODI), Numerical Pain Rating Scale (NRS).

Results: The participants exhibit negative believe toward back problems mean BBQ score = 25.8. The independent t-test indicated that female participants had significantly more negative beliefs compared to male participants with mean difference of -2.43 ( 95% CI: - 4.78 to -0.074), t (113) = -2.034, p=0.04. The one-way ANOVA showed a significant difference in BBQ score between working status categories F(2,112) = 4.30, p = 0.016. Post-hoc analysis using Hochberg's GT2 procedure indicated that not working participants had significantly more negative back beliefs, compared to working participants with mean difference of -3.29 ( 95% CI: - 6.03 to -0.54); F (2,112) = 4.30, p=0.013.
Further, a significant difference was found in beliefs among different disability levels F (3,111) = 3.99, p = 0.010. Post-hoc analysis using Hochberg's GT2 procedure indicated that participants with severe disability had significantly more negative beliefs compared to those with moderate disability with mean difference of -3.73 ( 95% CI: - 7.05 to -0.42) p =0.019.
The multiple regression analysis showed that Gender was a significant predictor of BBQ scores explaining 3.6% of variance in BBQ . Patients work status significantly predicted 3.9% of variance in BBQ after controlling for influence of patient's Gender. Disability level had significantly explained an additionally 8.1% of variance in BBQ beyond what was already explained by Gender and work status of the individual.

Conclusion(s): This study showed that individuals in clinical setting had negative back beliefs. These beliefs, significantly differed according to gender, work status and disability scores but not according to pain intensity and pain episodes. The association between back beliefs and disability support its' role in the development of disable LBP, which highlight importance of assessment of psychological status including back pain beliefs.

Implications: Assessment of negative beliefs toward back problems may help clinicians in early identification of patients who may develop disability in future due to back pain.

Keywords: Back pain Beliefs, Disability, Low Back Pain

Funding acknowledgements:
Grant was received from Research Center of Female Scientific and Medical Colleges, Deanship of Scientific Research, King Saud University.

Topic: Musculoskeletal: spine; Disability & rehabilitation

Ethics approval required: Yes
Institution: King Khalid University hospital
Ethics committee: ِEthical review board
Ethics number: -


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