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The influence of psychological factors on pre-operative levels of pain intensity, disability and HRQOL in lumbar spinal fusion surgery patients
Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0002-4318-9216
Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
Institute for Clinical Sciences, Department for Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
2010 (English)In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 96, no 3, 213-221 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.

DESIGN:

Cross-sectional, correlation study.

SETTING:

Orthopaedic outpatient setting in a tertiary hospital.

PARTICIPANTS:

One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.

MEASURES:

Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.

RESULTS:

The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.

CONCLUSIONS:

This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.

Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2010. Vol. 96, no 3, 213-221 p.
Keyword [en]
Spinal fusion, Disability, Quality of life, Mental disorders, Fear avoidance, Mediation
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-113851DOI: 10.1016/j.physio.2009.11.013ISI: 000281889800005PubMedID: 20674653Scopus ID: 2-s2.0-77955309735OAI: oai:DiVA.org:liu-113851DiVA: diva2:785141
Available from: 2015-02-02 Created: 2015-02-02 Last updated: 2017-12-05Bibliographically approved

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Abbott, Allan

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