The correlation between illness perception, pain intensity and quality of life in elderly with low back pain in Denmark: a cross-sectional study

Abstract

Background Illness perception is related to management patterns and pain intensity, but among elderly with low back pain, this relation is unclear. The aims of this study were to analyse the associations between illness perception, pain intensity and health related quality of life in a group of elderly with low back pain and explore how different illness perception profiles would cluster and differ in terms of pain, quality of life and choice of management. Method This was a cross-sectional survey based on a cohort of originally 640 Danish children. Of the 311 respondents in 2019, 69% reported low back pain within last year and were included. Associations between illness perceptions (Brief illness perception questionnaire), health related quality of life (EuroQol-5 Domain-3L) and low back pain intensity were assessed, and participants were clustered based on their perceptions using hierarchical and K-means cluster analysis. Cluster differences in pain, quality of life and use of pharmacological and non-pharmacological treatments were explored. Results Among the 213 individuals with low back pain, 33% reported severe or fluctuating pain intensity. Higher pain intensity was associated with perceiving low back pain as a greater threat. Participants reporting fluctuating pain perceived their low back pain almost as threatening as participants reporting severe pain. Two clusters were identified. Cluster 1 reported lower quality of life (difference in medians: −0.176 (95% CI [−0.233–−0.119 ])) and was more likely to report severe or fluctuating pain (37.7% vs. 4.5% [P < 0.0001]) and to use pharmacological treatments than Cluster 2 (37.7% vs. 14.9% [P < 0.001]). No association was found between clusters concerning use of non-pharmacological treatments (P = 0.134). Conclusion Based on illness perceptions, two clusters differing in pain intensity, quality of life and use of pharmacological treatments were identified. Targeting illness perceptions may be beneficial during rehabilitation or when guiding patients with low back pain in choice of management.

Sociodemographic and clinical variables associated with negative illness perception in patients newly diagnosed with rheumatoid arthritis, axial spondyloarthritis, or psoriatic arthritis—a survey based cross-sectional study

“…Based on the results from other studies [ 38 , 39 ], we initially anticipated that being female would be a risk factor. However, no significant associations were found in the adjusted analysis.…”

Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium

“…HRQoL is impacted by chronic BP in different domains of life, such as physical and mental well-being, social relationships, and functional capacity [ 23 ]. In a recent study, greater pain intensity was associated with the perception of BP as a greater threat and lower HRQoL [ 35 ]; the more pain participants experienced, the worse their HRQoL [ 36 ].. A comparison between individuals who reported BP and matched pain-free controls indicated that older adults people with BP reported significantly impaired HRQoL scores and a significantly lower self-assessment of general health [ 37 ]. In the present study, participants from both countries had an impact of the intensity of BP on their HRQoL, but the intensity of pain reflected on HRQoL was lower in Brazilian older adults.…”

Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium

“…HRQoL is impacted by chronic BP in different domains of life, such as physical and mental well-being, social relationships, and functional capacity [21]. In a recent study, greater pain intensity was associated with the perception of BP as a greater threat and lower HRQoL [32]; the more pain participants experienced, the worse their HRQoL. [33].…”