Medpagetoday.com
REPORTS HERE that "among patients with low back pain, negative beliefs and behaviors --
such as believing their problem will not get better -- are important
correlates of increased disability..."
"In data culled from questionnaires, patients with high levels of
disability associated with low back pain expressed significantly more
negative beliefs about physical activity, time off work, and the need
for bed rest compared with those reporting low levels of disability" the study reported.
"In contrast, pain intensity and functional health literacy skills did
not correlate with patients' disability levels, the researchers
reported online in the journal Pain. Poor health literacy -- an individual's ability to seek,
understand, and utilize health information -- has been linked with
limited self-management skills in other chronic conditions such as
asthma and rheumatoid arthritis, but the influence of health literacy
has not previously been investigated in low back pain."
"In addition, differences in these skills between low back pain
patients who report high and low levels of disability have not yet been
explored, which could have implications for prevention and treatment
strategies." So the authors analyzed data to see.
"Scores on the short form Test of Functional Health Literacy in Adults
were found to be adequate in all study participants, with no
differences in scores between patients with and without back pain or
according to level of disability. Literacy scores also were not associated with back pain beliefs, fear
avoidance beliefs, or pain catastrophizing."
"To analyze potential differences according to level of disability,
patients were subdivided according to the Oswestry Disability Index.
Those with greater disability reported...Higher
levels of fear avoidance beliefs about physical activity; More negative back pain beliefs; and More pain catastrophizing."
"Patients with high levels of disability were less optimistic that
their condition would improve because of their age, lack of mobility,
and overall "wear and tear," while those with low disability believed
that their symptoms would improve with health education and treatment."
"Patients in both groups named health professionals as their primary
source for information about low back pain and favored physiotherapists
and chiropractors over [medical] care physicians for specialized
information."
"Patients also relied on family and friends for information, and those
with high disability further sought information on the Internet and
from medical literature. All agreed that mass media campaigns about low
back pain would be helpful."
"Participants "overwhelmingly" stated that understanding their
condition, its causes, and its management was hampered by the overuse of
complex medical terminology, and requested more use of visual diagrams
and skeletal models for explanations."
"They also admitted that they often did not follow prescribed
treatment regimens, but said that if they were given clearer information
and more fully understood the condition and its treatments they would
be more likely to be adherent. Other contributors to lack of treatment utilization included costs
and lack of time."
