Health literacy and beliefs among a community cohort with and without chronic low back pain

Briggs, AM; Jordan, J M; Buchbinder, Rachelle; Straker, LM; Burnett, AF; O'Sullivan, PB; Metcalf, David Michael; Chua, Jason; Osborne, R.H.

doi:10.1016/j.pain.2010.04.031

Cited by 144 publications

(204 citation statements)

References 62 publications

Supporting

Mentioning

183

Contrasting

Unclassified

Order By: Relevance

“…31 Patients filter, interpret, and remember information at the level of their understanding and in the context of their preexisting beliefs and motives. The data are, however, entirely consistent with what health care professionals report providing, 13,32 people with low back pain report receiving, 14,15 and direct consultation observations. 33 Regardless of participants' recall and bias, the messages that have stayed with them are probably more important than what was actually said or intended.…”

Section: Limitationssupporting

confidence: 77%

“…10,12,13 People with low back pain receive information from a range of sources, but the influence of each source is unknown. 14,15 Studies have investigated activities, situations, and anatomic structures that people see as being responsible for their back pain, but not how or why beliefs have been formed. 14,[16][17][18] Health care professionals may negatively influence patient beliefs.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 Studies have investigated activities, situations, and anatomic structures that people see as being responsible for their back pain, but not how or why beliefs have been formed. 14,[16][17][18] Health care professionals may negatively influence patient beliefs. 19 There is strong evidence that patients' beliefs about low back pain are associated with their clinicians' beliefs, and moderate evidence suggests that patient and clinician fear avoidance beliefs are also associated.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Enduring Impact of What Clinicians Say to People With Low Back Pain

Darlow

Dowell

Baxter

et al. 2013

The Annals of Family Medicine

228

154

View full text Add to dashboard Cite

PURPOSE The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.METHODS Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks' duration) and 11 participants with chronic low back pain (more than 3 months' duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.RESULTS Participants' underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding. Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients' understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years. Many messages from clinicians were interpreted as meaning the back needed to be protected. These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed. Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.CONCLUSIONS Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs. INTRODUCTIONL ow back pain is a health condition with major direct and indirect costs.1-4 Acute low back pain is assumed to have a highly positive prognosis 5 ; however, a large proportion of patients continue to experience pain and disability. 6 Psychosocial factors are important in the development of low back pain and disability. 7,8 Depression, passive coping strategies, fear avoidance beliefs (the avoidance of movement or activity resulting from fear of pain or injury), and low expectations of recovery are independently associated with poor outcome.9,10 A clinical guide to assessing psychosocial warning signs (yellow flags) developed in New Zealand has been adopted internationally. Patients' beliefs need to be better understood to improve management of low back pain. 10,12,13 People with low back pain receive information from a range of sources, but the influence of each source is unknown.14,15 Studies have investigated activities, situations, and anatomic structures that people see as being responsible for their back pain, but not how or why beliefs have been formed. 14,[16][17][18] Health care professionals may negatively influence patient beliefs. 19There is strong evidence that patients' beliefs about low back pain are associated with their clinicians' beliefs, and moderate evidence suggests

show abstract

Section: Limitationssupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Enduring Impact of What Clinicians Say to People With Low Back Pain

Darlow

Dowell

Baxter

et al. 2013

The Annals of Family Medicine

228

154

View full text Add to dashboard Cite

show abstract

“…Although most people experience some form of LBP at some point in their lives, a diagnosis for the pain experience can infrequently be determined on the basis of a spinal structural disorder [3]. Consequently, most LBP episodes are diagnostically classified as 'non specific LBP' and this remains a source of frustration for patients [4] trying to understand their problem and uncertainty for clinicians developing treatment plans.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of MRI-defined spinal pathoanatomies and their association with Modic changes in individuals seeking care for low back pain

et al. 2011

Self Cite

View full text Add to dashboard Cite

Modic changes are of increasing interest, however their age and gender prevalence are not well described. To date, the associations between Modic changes and other common vertebral pathologies have only been described in small samples (n \ 100). Our aim was, in a large dataset of people with low back pain, to (1) describe the prevalence of a range of spinal pathoanatomies, and (2) examine the association between Modic changes and stages of intervertebral disc (IVD) pathology. Common pathologies were coded from the lumbar spine MRIs from 4,233 consecutive people imaged while attending a publicly-funded secondary care outpatient facility in Denmark. Prevalence data were calculated by pathology and by vertebral level. Prevalence was also calculated by age and gender categories for Modic changes. The association between stages of IVD pathology (degeneration, bulge, herniation) and Modic changes at L4/5 and L5/S1 was expressed using prevalence ratios (PR) and 95% confidence intervals. The prevalence of Modic changes and IVD pathology were greater in L4/ 5 and L5/S1, compared with the upper lumbar spine. There was no significant gender difference in prevalence of Modic changes (p = 0.11). The prevalence of IVD disc pathology occurring concurrently with Modic changes ranged from 11.5 to 17.5% (Type 1), 8.5 to 12.7% (Type 2) and 17.1 to 25.6% (Type 1 and/or 2) while the prevalence occurring in the absence of Modic changes ranged from 0.5 to 6.3% (Type 1), 0.3 to 4.9 (Type 2), 0.8 to 9.7% (Type 1 and/or 2). The associated PR for IVD pathology occurring concurrently with Modic changes ranged from 1.8 to 29.2 (p \ 0.05). The highest PR (29.2) was between degeneration and Modic changes, indicating that it is rare for Modic changes to occur without disc degeneration. Spinal pathoanatomy was common in this population, particularly IVD pathologies, and a consistent trend of a relatively greater prevalence in the lower lumbar spine was identified. Modic changes were more likely to be present among individuals with IVD pathology than without, which may implicate mechanical factors as being one aetiological pathway for Modic changes, although other hypotheses may equally explain this association.

show abstract

“…Fear avoidance may lead to interference in activities of daily living (ADL) and may play an active role in the transition from acute to chronic pain [13,14]. It has been demonstrated that fear-avoidance beliefs were linked to the degree of disability, and that those with higher fear-avoidance beliefs have a higher level of disability [15]. Another study recommended that fear avoidance beliefs need to be considered in the management of pain and disability caused by LBP [16].…”

Section: Research Syamala Buragaddamentioning

confidence: 99%