Combined effects of psychological and life style factors on pain intensity and/or disability in patients with chronic low back pain: A cross-sectional study
Notice bibliographique
Résumé
Introduction Chronic Lower Back Pain (CLBP) is a frequently encountered health issue in primary care settings, leading to global disability and imposing a considerable economic burden. Objectives This study aimed to: (1) compare socio-demographic, health, lifestyle (sleep, physical activity) and psychological factors (depression, anxiety) between people with and without CLBP; and (2) quantify the correlations between these psychological and lifestyle factors, and clinical outcomes (intensity of CLBP and CLBP-related disability) in people with CLBP after considering other confounders. Methods A cross-sectional study was undertaken at the neurosurgery and orthopedic outpatient department of Heraklion University Hospital between 2019-2021. Two hundred fifty three volunteers with CLBP and 116 without CLBP provided sociodemographic information, daily habits, medical history, subjective sleep/ sleep complaints, low back pain intensity and disability using a10-point numeric Visual Analogue Scale pain rating scale and Quebec Back Pain Disability Scale, as well as questions assessing impact of pain on mobility, self-care, routine activities and psychological status, respectively. Participants also completed the Zung Self-Rating Scale (SDS) for self-assessment of depression and Self-rating anxiety scale (SAS). Associations among CLBP, demographics, psychosocial or sleep disorders parameters and clinical outcomes were analyzed using multivariate models. Results People with CLBP exhibited a substantially greater prevalence of depressive, insomnia and obstructive sleep apnea (OSA) symptoms than controls ( p < 0.05). CLBP diagnosis was independently correlated with female gender, older age, as well as worse physical and mental health outcomes measured by (i) higher level of sleep symptoms such as sleepiness, OSA and insomnia symptoms and (ii) higher prevalence of physician-diagnosed depression, and moderate to severe depressive symptoms. The level of functional disability for CBLP patients (based on Quebec score) was independently associated with age, physician diagnosed depression, lower educational status, moderate to severe depressive symptoms and OSA symptoms. The combination of moderate to severe depressive symptoms with OSA or insomnia symptoms was the most important predictive factor for functional disability for CBLP patients (OR 13.686, 95% CI 4.581-40.885; p<0.001). Conclusions Depressive symptoms and subjective sleep disorders appear to relate to greater CLBP-intensity and/or CLBP-related disability in people with CLBP. To achieve the desired outcomes when treating patients with chronic CLBP, it is essential to employ a holistic approach, involving assessment and management of their psychological comorbidities, and sleep issues, that may improve quality of life in these patients. Disclosure of Interest None Declared
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».