Model of quality of life in a group of people with chronic low back pain
Słowa kluczowe:
quality of life, model of quality of life, chronic low back pain (CLBP)Abstrakt
Background:
Chronic low back pain (CLBP) is one of the leading causes of a reduction in the quality of life (QoL). Various methods ef-fectively improve patients’ performance and coping with their symptoms in the short term. The lack of focus on psychologi-cal factors, thus overlooking an important element of the holistic model, may result in the modest long-term improvement. The present study aimed to test the relationships between the variables in Wilson and Cleary’s QoL model in a CLBP group and to compare them to a nonpain group.
Participants and procedure:
Data were obtained from 177 people with CLBP and 160 nonpain participants. We conducted a cross-sectional study in which a multi-module self-administered questionnaire examining biological factors, personality traits, personal values, body assessment, symptoms of depression and anxiety, functional status, general perception of health, life satisfaction, received social support, economic support, satisfaction of health care and sociodemographic factors was adopted.
Results:
Multiple regression models were able to explain 48.4% of the variance of QoL in the CLBP group and 30.9% in the nonpain group. Statistically significant predictors in the CLBP model were the severity of anxiety, emotional stability, receiving social support, and general health assessment and emotional stability in the nonpain group.
Conclusions:
The study has enabled an initial exploratory analysis of the Wilson and Cleary model in a CLBP group. The list of factors determining the QoL should be extended to include emotional stability, social and economic support. Further research is needed to explain the relationships between variables in the model.
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Bibliografia
Alhowimel, A., AlOtaibi, M., Radford, K., & Coulson, N. (2018). Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: a systematic review. SAGE Open Medicine, 6, 1–8. https://doi.org/10.1177/2050312118757387.
Artus, M., van der Windt, D. A., Jordan, K. P., & Hay, E. M. (2010). Low back pain symptoms show a similar pattern of improvement following a wide range of primary care treatments: a systematic review of randomized clinical trials. Rheumatology, 49, 2346–2356. https://doi.org/0.1093/rheumatology/keq245.
Baker, S. R., Pankhurst, C. L., & Robinson, P. G. (2006). Testing relationships between clinical and nonclinical variables in xerostomia: a structural equation model of oral health-related quality of life. Quality of Life Research, 16, 297–308. https://doi. org/10.1007/s11136-006-9108-x.
Bentler, P. M., & Chou, C. P. (1987). Practical issues in structural modeling. Sociological Methods and Research, 16, 78–117. https://doi.org/10.1177/ 0049124187016001004.
Bilsky, W., & Schwartz, S. H. (1994). Values and personality. European Journal of Personality, 8, 163– 181. https://doi.org/10.1002/per.2410080303.
Campbell, P., Wynne‐Jones, G., & Dunn, K. M. (2011). The influence of informal social support on risk and prognosis in spinal pain: a systematic review. European Journal of Pain, 15, 444–e1. https://doi. org/10.1016/j.ejpain.2010.09.011.
Cieciuch, J. (2013). Pomiar wartości w zmodyfikowanym modelu Shaloma Schwartza [Value measurement in the modified Shalom Schwartz model]. Psychologia Społeczna, 8, 22–41.
Cieciuch, J., & Zaleski, Z. (2011). Polska adaptacja Portretowego Kwestionariusza Wartości Shaloma Schwartza [Polish adaptation of Shalom Schwartz’s Portrait Questionnaire of Values (PVQ)]. Czasopismo Psychologiczne, 17, 251–262.
Cleeland, C. S., & Ryan, K. M. (1991). The Brief Pain Inventory. User guide. Pain Research Group. Cosby, C., Holzemer, W. L., Henry, S. B., & Portillo, C. J. (2000). Hematological complications and quality of life in hospitalized AIDS patients. AIDS Patient Care and STDs, 14, 269–279. https://doi. org/10.1089/108729100317731.
Costa, P. T. Jr., & McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO FiveFactor Inventory (NEOFFI) professional manual. Psychological Assessment Resources.
Cvijetic, S., Bobic, J., Grazio, S., Uremovic, M., Nemcic, T., & Krapac, L. (2014). Quality of life, personality and use of pain medication in patients with chronic back pain. Applied Research in Quality of Life, 9, 401–411. https://doi.org/10.1007/s11482-013- 9219-9.
Czapiński, J., & Panek, T. (Eds.). (2015). Diagnoza społeczna; kwestionariusze [Social diagnosis; questionnaires]. Rada Monitoringu Społecznego. Retrieved from www.diagnoza.com.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75. https://doi. org/10.1207/s15327752jpa4901_13.
Dourouka, V., Vlastos, D. D., & Theofilou, P. (2023). Psychotherapy and chronic pain management: a quantitative study evaluating the contribution of psychotherapy to quality of life and treatment compliance in chronic disease patients. Health Psychology Report. https://doi.org/10.5114/hpr/171847.
Faraji, E., Moghtader, L., & Majareh, S. A. (2019). The relationship between social support and the personality traits of extroversion and neuroticism and psychological well-being in women with chronic pain. Anesthesiology and Pain, 9, 29–40.
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191. https://doi.org/10.3758/bf03193146.
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160. https://doi. org/10.3758/BRM.41.4.1149.
Fegg, M. J., Wasner, M., Neudert, C., & Borasio, G. D. (2005). Personal values and individual quality of life in palliative care patients. Journal of Pain and Symptom Management, 30, 154–159. https://doi. org/10.1016/j.jpainsymman.2005.02.012.
Franzoi, S. L., & Koehler, V. (1998). Age and gender differences in body attitudes: a comparison of young and elderly adults. The International Journal of Aging and Human Development, 47(1), 1–10. https:// doi.org/10.2190/FVG1-GE5A-8G5Y-DXCT.
Franzoi, S. L., & Shields, S. A. (1984). The Body Esteem Scale: Multidimensional structure and sex differ ences in a college population. Journal of Personality Assessment, 48, 173–178. https://doi.org/10.1207/ s15327752jpa4802_12.
Frühwald, S., Löffler, H., Eher, R., Saletu, B., & Baumhackl, U. (2001). Relationship between depression, anxiety and quality of life: a study of stroke patients compared to chronic low back pain and myocardial ischemia patients. Psychopathology, 34, 50–56. https://doi.org/10.1159/000049280.
Golicki, D., Jakubczyk, M., Niewada, M., Wrona, W., & Busschbach, J. J. (2010). Valuation of EQ‐5D Health States in Poland: First TTO‐based social value set in Central and Eastern Europe. Value in Health, 13, 289–297. https://doi.org/10.1111/j.1524- 4733.2009.00596.x.
Guclu, D. G., Guclu, O., Ozaner, A., Senormanci, O., & Konkan, R. (2012). The relationship between disability, quality of life and fear-avoidance beliefs in patients with chronic low back pain. Turkish Neurosurgery, 22, 724–731. https://doi.org/10.5137/1019- 5149.JTN.6156-12.1.
Haraldstad, K., Wahl, A., Andenæs, R., Andersen, J. R., Andersen, M. H., Beisland, E., Borge, C. R., Engebretsen, E., Eisemann, M., Halvorsrud, L., Hanssen, T. A., Haugstvedt, A., Haugland, T., Johansen, V. A., Larsen, M. H., Lřvereide, L., Lřyland, B., Kvarme, L. G., Moons, P., … Hanssen, T. A. (2019). A systematic review of quality of life research in medicine and health sciences. Quality of Life Research, 28, 2641– 2650. https://doi.org/10.1007/s11136-019-02214-9.
Helgeson, V. S. (2003). Social support and quality of life. Quality of Life Research, 12, 25–31. https://doi. org/10.1023/A:1023509117524.
Holland, P. W. (1988). Causal inference, path analysis and recursive structural equations models. ETS Research Report Series, 1, i–50. https://doi. org/10.1002/j.2330-8516.1988.tb00270.x.
Horng, Y. S., Hwang, Y. H., Wu, H. C., Liang, H. W., Mhe, Y. J., Twu, F. C., & Wang, J. D. (2005). Predicting health-related quality of life in patients with low back pain. Spine, 30, 551–555. https://doi. org/10.1097/01.brs.0000154623.20778.f0.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., Williams, G., Smith, E., Vos, T., Barendregt, J., Murray, C., Burstein, R., & Buchbinder, R. (2014). The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Annals of Rheumatic Diseases, 73, 968–974. https://doi.org/10.1136/annrheumdis-2013-204428.
Huang, I. C., Lee, J. L., Ketheeswaran, P., Jones, C. M., Revicki, D. A., & Wu, A. W. (2017). Does personality affect health-related quality of life? A systematic review. PloS One, 12, e0173806. https://doi. org/10.1371/journal.pone.0173806.
Jankowski, K. S. (2015). Is the shift in chronotype associated with an alteration in well-being? Biological Rhythm Research, 46, 237–248. https://doi.org/10. 1080/09291016.2014.985000.
Jonsson, E., Olafsson, G., Fritzell, P., Hägg, O., & Borgström, F. (2016). Costs and quality of life of low back pain: a multi-register based national treatment pathway model in Sweden. Value in Health, 19, A536. https://doi.org/10.1016/j.jval.2016.09.1099.
Juczyński, Z. (2001). Skala satysfakcji z życia – SWLS [Satisfaction with Life Scale – SWLS]. In Z. Juczyński (Ed.), Narzędzia pomiaru w promocji i psychologii zdrowia [Measurement tools in health promotion and psychology] (pp. 134–141). Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego.
Kasser, T., & Ahuvia, A. (2002). Materialistic values and well‐being in business students. European Journal of Social Psychology, 32, 137–146. https:// doi.org/10.1002/ejsp.85.
Ketiš, Z. K. (2011). Predictors of health-related quality of life and disability in patients with chronic nonspecific low back pain. Slovenian Medical Journal, 80, 379–385.
Kokoszka, A. (2008). Krótka Skala Samooceny Depresji i Lęku: opis konstrukcji oraz właściwości psychometryczne dla osób z cukrzycą [Breif SelfRating Scale of Depression and Anxiety: Description of construction and psychometric properties for people with diabetes]. Przewodnik Lekarza, 6, 74–81.
Kong, W. M., Sheikh, M. H., Lumb, P. J., Naoumova, R. P., Freedman, D. B., Crook, M., Doré, C. J., & Finer N. (2002). A 6-month randomized trial of thyroxine treatment in women with mild subclinical hypothyroidism. The American Journal of Medicine, 112, 348–354. https://doi.org/10.1016/s0002-9343(02)01022-7.
Krishnan, S. M. (2020). Package valueEQ5D: Scoring the EQ-5D Descriptive System. Retrieved from https:// cran.r-project.org/web/packages/valueEQ5D/index.html.
Leppert, W., & Majkowicz, M. (2010). Polish brief pain inventory for pain assessment and monitoring of pain treatment in patients with cancer. Journal of Palliative Medicine, 13, 663–668. https://doi. org/10.1089/jpm.2009.0326.
Lipowska, M., & Lipowski, M. (2013). Polish normalization of the Body Esteem Scale. Health Psychology Report, 1, 72–81. https://doi.org/10.5114/ hpr.2013.40471.
Łuszczyńska, A., Kowalska, M., Mazurkiewicz, M., & Schwarzer, R. (2006). Berlińskie Skale Wsparcia Społecznego (BSSS): Wyniki wstępnych badań nad adaptacją skal i ich właściwości psychometrycznymi [Berlin Social Support Scales (BSSS): Results of preliminary research on the adaptation of the scales and their psychometric properties]. Studia Psychologiczne, 44, 17–27.
Markey, C. H., Dunaev, J. L., & August, K. J. (2020). Body image experiences in the context of chronic pain: an examination of associations among perceptions of pain, body dissatisfaction, and positiv body image. Body Image, 32, 103–110. https://doi. org/10.1016/j.bodyim.2019.11.005.
McHugh, J. E., & Lawlor, B. A. (2012). Social support differentially moderates the impact of neuroticism and extraversion on mental wellbeing among community-dwelling older adults. Journal of Mental Health, 21, 448–458. https://doi.org/10.3109/096 38237.2012.689436.
McMahon, S. B., Koltzenburg, M., Tracey, I., & Turk, D. (Eds.). (2013). Wall & Melzack’s textbook of pain (6th ed.). Elsevier Health Sciences.
Medgyesi, M., & Zólyomi, E. (2016). Job satisfaction and satisfaction in financial situation and their impact on life satisfaction. European Commission.
Megari, K. (2013). Quality of life in chronic disease patients. Health Psychology Research, 1, 27. https:// doi.org/10.4081/hpr.2013.e27.
Peñacoba-Puente, C., Fernández-de-las-Peñas, C., González-Gutierrez, J. L., Miangolarra-Page, J. C., & Pareja, J. A. (2008). Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache. European Journal of Pain, 12, 886–894. https://doi.org/10.1016/ j.ejpain.2007.12.016.
Pincus, T., Kent, P., Bronfort, G., Loisel, P., Pransky, G., & Hartvigsen, J. (2013). Twenty-five years with the biopsychosocial model of low back pain – Is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine, 38, 2118–2123. https://doi. org/10.1097/BRS.Ob013e3182a8c5d6.
Sagiv, L., & Schwartz, S. H. (2000). Value priorities and subjective well‐being: Direct relations and congruity effects. European Journal of Social Psychology, 30, 177–198. https://doi.org/10.1002/ (SICI)1099-0992(200003/04)30:23.0.CO;2-Z.
Schaller, A., Dejonghe, L., Haastert, B., & Froboese, I. (2015). Physical activity and health-related quality of life in chronic low back pain patients: a crosssectional study. BMC Musculoskeletal Disorders, 16, 62. https://doi.org/10.1186/s12891-015-0527-0.
Schulz, U., & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49, 73–82. https://doi. org/10.1026/0012-1924.49.2.73.
Schwartz, S., Cieciuch, J., Vecchione, M., Davidov, E., Fischer, R., Beierlein, C., Ramos, A., Verkasalo, M., Lönnqvist, J. E., Demirutku, K., Dirilen-Gumus, O., & Konty, M. (2012). Refining the theory of basic individual values. Journal of Personality and Social Psychology, 103, 663–688. https://doi.org/10.1037/ a0029393.
Schwartz, S. H., & Sortheix, F. M. (2018). Values and subjective well-being. In E. Diener, S. Oishi, & L. Tay (Eds.), Handbook of well-being (pp. 1–25).
DEF Publishers. Soriano, J., Monsalve, V., Gómez-Carretero, P., & Ibáñez, E. (2012). Vulnerable personality profile in patients with chronic pain: Relationship with coping, quality of life and adaptation to disease. International Journal of Psychological Research, 5, 41–50. https://doi.org/10.21500/20112084.748.
Sorokowska, A., Słowińska A., Zbieg A., & Sorokowski, P. (2014). Polska adaptacja testu Ten Item Personality Inventory (TIPI) – TIPI-PL – wersja standardowa i internetowa [Polish adaptation of the Ten Item Personality Inventory (TIPI) test – TIPI-PL – standard and online version]. WrocLab. https:// doi.org/10.13140/2.1.4811.5521.
Stevens, J. P. (2012). Applied multivariate statistics for the social sciences. Routledge.
Tabachnick, B. G., Fidell, L. S., & Ullman, J. B. (2007). Using multivariate statistics. Pearson.
Van Reenen, M., & Janssen, B. (2015). EQ-5D-5L user guide: Basic information on how to use the EQ-5D-5L instrument. EuroQol Research Foundation.
Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. Jama, 273, 59–65. https://doi.org/10.1001/jama.273.1.59.
Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81, 646–656.
Wynne-Jones, G., Cowen, J., Jordan, J. L., Uthman, O., Main, C. J., Glozier, N., & van der Windt, D. (2014). Absence from work and return to work in people with back pain: a systematic review and metaanalysis. Occupational and Environmental Medicine, 71, 448–456. https://doi.org/10.1136/oemed2013-101571.
Yamada, K., Matsudaira, K., Takeshita, K., Oka, H., Hara, N., & Takagi, Y. (2014). Prevalence of low back pain as the primary pain site and factors associated with low health-related quality of life in a large Japanese population: a pain-associated cross-sectional epidemiological survey. Modern Rheumatology, 24, 343–348. https://doi.org/10.3109/14397595. 2013.854067.