The Influence of Fear Avoidance Beliefs on Disability and Quality of Life is Sparse in Spanish Low Back Pain Patients

Abstract

As opposed to what has been shown in other cultural settings, FAB have virtually no clinical relevance in Spanish LBP patients who are treated in the National Health Service and who are in a potentially active working situation. The influence of FAB on disability is minimal and much less than that of pain severity, and their contribution to the patient's quality of life is irrelevant. Further studies should explore the potential value of FAB in other Latin-Mediterranean countries.

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

“…Some studies have found differences in how back pain is faced among different cultural backgrounds by patients [30] and by health care providers [15,16]. For example, Kovacs et al [18] demonstrated that in Spanish LBP patients the influence of fearavoidance beliefs is sparse in disability.…”

“…There is evidence which suggests that the beliefs and attitudes about LBP differ according to the cultural background in which they are explored [14][15][16][17][18]. The purpose of this study is to validate the Spanish version of the HC-PAIRS questionnaire and investigate its psychometric properties and factor structure in a sample of Spanish physiotherapy students and family physicians.…”

The prognostic value of catastrophizing for predicting the clinical evolution of low back pain patients: a study in routine clinical practice within the Spanish National Health Service

“…Therefore, as opposed to randomized clinical trials, there were no ethical reasons for keeping the sample size as small as possible. As a result, sample size for this study was established at 1,500, in order to ensure enough statistical power, given that: a) previous studies had suggested that the potential effect of catastrophizing in Spanish subjects could be small, 10,11,16 b) approximately 80% of LBP patients treated in routine practice within the Spanish National Health Service, report a clinically relevant improvement at 3 months, 36,37 and previous studies have shown that improvements are not normally distributed, 36,38 which excludes linear regression analysis and implies the need to dichotomize continuous variables for logistic regression analyses, which in turn may reduce statistical power, d) this sample size would allow the introduction of up to 30 variables in the regression models as potential confounders. 39 …”

“…[1][2][3][4][5][6][7][8][9] FAB refer to the fear-induced avoidance of movements or activities which are expected to be painful, whereas catastrophizing is defined as an exaggerated negative mental state related to an actual or anticipated painful experience. [1][2][3][4][5][6][7][8][9] In the Spanish cultural environment, FAB have shown to have an either negligible or nonexistent influence on LBP among elderly populations and among acute, subacute and chronic LBP patients treated in routine practice, [10][11][12][13] whereas catastrophizing correlates with disability and explains approximately one fourth of its variance, 13,14 suggesting that it may have an influence on the prognosis of LBP patients.…”

Versão brasileira do Fear Avoidance Beliefs Questionnaire

“…Dentre os distúrbios dolorosos, a dor lombar constitui uma causa freqüente de morbidade e incapacidade, sendo ultrapassada somente pela cefaléia 7 . Pelos elevados índices de prevalência, morbidade, diminuição de produtividade, absenteísmo e incapacidade para o trabalho, as lombalgias são consideradas um dos grandes problemas de saúde pública dos países industrializados 8 .…”