Wertli, Maria Monika; Held, Ulrike; Lis, Angela; Campello, Marco; Weiser, Sherri (2018). Both positive and negative beliefs are important in patients with spine pain: findings from the Occupational and Industrial Orthopaedic Center registry. Spine Journal, 18(8), pp. 1463-1474. Elsevier 10.1016/j.spinee.2017.07.166
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BACKGROUND CONTEXT
Negative beliefs are known to influence treatment outcome in patients with spine pain (SP). The impact of positive beliefs is less clear.
PURPOSE
We aimed to assess the influence of positive and negative beliefs on baseline and treatment responses in patients with SP.
STUDY DESIGN/SETTING
A retrospective cross-sectional and longitudinal analysis of prospectively collected data of outpatient physical therapy patients with SP was carried out. Questionnaires administered before and during treatment included the STarT Back distress scale (negative beliefs), and expectation and self-efficacy questions (positive beliefs).
PATIENT SAMPLE
Patients with SP with a baseline assessment and follow-up assessment comprised the study sample.
OUTCOME MEASURE
Perceived disability was measured using the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI). A clinical meaningful change (minimum clinically important difference [MCID]) was defined as decrease in ODI or NDI of ≥30%.
METHODS
We used the Akaike Information Criterion from the first imputed dataset of the prediction model to select predictor variables. Prediction models were fitted to the outcome variables.
RESULTS
In the cross-sectional analysis, 1,695 low back pain (LBP) episodes and 487 neck pain (NP) episodes were analyzed. STarT Back Screening Tool (SBST)-distress was positively associated with perceived disability in both LBP (beta 2.31, 95% confidence interval [CI] 1.75-2.88) and NP (beta 2.57, 95% CI 1.47-3.67). Lower self-efficacy was negatively associated with more perceived disability for LBP (beta 0.50, 95% CI 0.29-0.72) but not for NP, whereas less positive expectations was associated with more perceived disability in NP (beta 0.57, 95% CI 0.02-1.12) but not in LBP. In the longitudinal analysis, 607 LBP episodes (36%) and 176 (36%) NP episodes were included. SBST-distress did not predict treatment outcome in spine patients. In LBP, patients with a lower positive expectation were less likely to experience an MCID in perceived disability (odds ratio [OR] per point increase 0.89, 95% CI 0.83-0.96), and there was a similar trend in NP (OR per point increase 0.90, 95% CI 0.79-1.03). In patients with LBP, lower self-efficacy at baseline was associated with a higher likelihood that an MCID was achieved (OR per point increase 1.09, 95% CI 1.01-1.19). In NP, self-efficacy was not included in the final model.
CONCLUSIONS
Our study demonstrates that both negative and positive beliefs are associated with perceptions of disability. However, in this study, only positive beliefs were associated with treatment outcome.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine |
UniBE Contributor: |
Wertli, Maria Monika |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1529-9430, 1878-1632 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Jacques Donzé |
Date Deposited: |
20 Mar 2018 11:19 |
Last Modified: |
05 Dec 2022 15:10 |
Publisher DOI: |
10.1016/j.spinee.2017.07.166 |
PubMed ID: |
28756302 |
Uncontrolled Keywords: |
Low back pain Neck pain Negative beliefs Outcome expectation Positive beliefs STarT Back Tool Self-efficacy Spine pain |
BORIS DOI: |
10.7892/boris.110686 |
URI: |
https://boris.unibe.ch/id/eprint/110686 |