Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin J Pain. 2015 Mar;31(3):254-64. doi: 10.1097/AJP.0000000000000108.

Psychological covariates of longitudinal changes in back-related disability in patients undergoing acupuncture.

Author information

1
*Department of Psychology †School of Mathematics ‡MRC Lifecourse Epidemiology Unit §School of Medicine, University of Southampton, Southampton, UK.

Abstract

OBJECTIVES:

To identify psychological covariates of longitudinal changes in back-related disability in patients undergoing acupuncture.

MATERIALS AND METHODS:

A longitudinal postal questionnaire study was conducted with data collection at baseline (pretreatment), 2 weeks, 3, and 6 months later. A total of 485 patients were recruited from 83 acupuncturists before commencing acupuncture for back pain. Questionnaires measured variables from 4 theories (fear-avoidance model, common-sense model, expectancy theory, social-cognitive theory), clinical and sociodemographic characteristics, and disability. Longitudinal multilevel models were constructed with disability over time as the outcome.

RESULTS:

Within individuals, reductions in disability (compared with the person's individual mean) were associated with reductions in: fear-avoidance beliefs about physical activity (β=0.11, P<0.01) and work (β=0.03, P<0.05), catastrophizing (β=0.28, P<0.05), consequences (β=0.28, P<0.01), concerns (β=0.17, P<0.05), emotions (β=0.16, P<0.05), and pain identity (β=0.43, P<0.01). Within-person reductions in disability were associated with increases in: personal control (β=-0.17, P<0.01), comprehension (β=-0.11, P<0.05) and self-efficacy for coping (β=-0.04, P<0.01). Between individuals, people who were less disabled had weaker fear-avoidance beliefs about physical activity (β=0.12, P<0.01), had more self-efficacy for coping (β=-0.07, P<0.01), perceived less severe consequences of back pain (β=0.87, P<0.01), had more positive outcome expectancies (β=-0.30, P<0.05), and appraised acupuncture appointments as less convenient (β=0.92, P<0.05).

DISCUSSION:

Illness perceptions and, to a lesser extent, self-efficacy and expectancies can usefully supplement variables from the fear-avoidance model in theorizing pain-related disability. Positive changes in patients' beliefs about back pain might underpin the large nonspecific effects of acupuncture seen in trials and could be targeted clinically.

PMID:
24901897
PMCID:
PMC4323559
DOI:
10.1097/AJP.0000000000000108
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer Icon for PubMed Central
    Loading ...
    Support Center