Biopsychosocial functioning and pain self-efficacy in chronic low back pain patients

Abstract

Abstract-The aim of this study was to examine the relationship between biopsychosocial functioning and pain severity and to evaluate whether pain self-efficacy (PSE) mediates this relationship. This study used archival data from a multidisciplinary pain management program. Participants were 99 individuals (69% female) with chronic low back pain who completed measures of biological, psychological, and social functioning; pain severity; and PSE at admission. They ranged in age from 18 to 72 yr (mean = 42.6, standard deviation = 12.1). Structural equation modeling and bootstrapping techniques were used to test the significance of the mediated model. As we predicted, lower biological functioning (beta = 0.011; 95% confidence interval [CI] = 0.019 to 0.004, p = 0.002) and social functioning (beta = 0.009; 95% CI = 0.016 to 0.003, p = 0.007) were found to significantly predict higher pain severity, and lower social functioning was found to significantly predict lower PSE (beta = 0.196; 95% CI = 0.130 to 0.273, p = 0.002). PSE did not mediate the relationship between biopsychosocial functioning and pain severity, and psychological functioning did not significantly predict pain severity or PSE. These findings suggest that social functioning is an important factor in predicting outcomes and has a number of treatment implications.

Fatores biopsicossociais associados com a incapacidade em idosos com dor lombar aguda: estudo BACE-Brasil

“…Previous data that indicate the influence of health status on LBP disability are consistent with this result 9,46 . However, it is essential to note that the available literature on LBP in the general population has shown meaningful participation of psychological and social issues in detriment of clinical and biological issues [18][19][20]37,44 . This is also evident in this study since several biological factors did not show a significant association with disability.…”

“…The scientific literature highlights the importance of the biopsychosocial model in the approach of LBP in the general population [17][18][19][20] . However, on the association of biopsychosocial factors with disability in LBP patients are still limited.…”

Chronic low back pain and the construction of illness identities in women from Kuwait

“…A lack of "specific" or physiological explanation for 85% of LBP may be due to the dominance of biomedical perspectives in conceptualising LBP (Koenig et al, 2014). This is particularly problematic for individuals whose pain has developed from acute to CLBP, since it has been acknowledged that psychosocial factors, or what clinicians" term "yellow flags", such as stress, anxiety, negative mood or emotions, poor work relationships and social support, are associated with an increased risk of CLBP (Koes et al, 2006).…”

“…Although these studies have provided important building blocks for a biopsychosocial understanding of chronic pain, they are suggested to be incomplete (Koenig et al, 2014). In order to propose a more comprehensive alternative to the biomedical model, the interconnection between social, psychological and cultural factors should be investigated in unison, rather than viewing them separately.…”

“…In other words, it is necessary to undertake research which aims to explain individuals" perspectives and behaviours in relation to their social situations, practices, and cultural ideologies. It is important to include all three areas of functioning in order to fully understand the heuristic model of CLBP and to best target interventions that address these areas (Koenig et al, 2014).…”