TY - JOUR
T1 - Fear of movement, passive coping, manual handling, and severe or radiating pain increase the likelihood of sick leave due to low back pain
AU - Dawson, Anna P.
AU - Schluter, Philip J.
AU - Hodges, Paul W.
AU - Stewart, Simon
AU - Turner, Catherine
N1 - Funding Information:
The research on which this article is based was conducted as part of the Nurses and Midwives e-Cohort Study ( http://www.e-cohort.net ), The University of Queensland. This project is supported by grants from the Australian Research Council ( LP0562102 , SR0566924 ), Australian National Health and Medical Research Council ( 2005002108 ), and New Zealand Health Research Council ( 456163 ). Industry Partners providing additional funding include: Queensland Health, the South Australian Department of Health, Injury Prevention and Control Australia (Pty Ltd) , Nursing Council of New Zealand and the Macquarie Bank Foundation . Industry partners providing in-kind support for the project include: Queensland Nursing Council, Nurses and Midwives Board of New South Wales, Nurses Board of Tasmania, Nurses Board of Western Australia, Nurses Board of the Australian Capital Territory, and the Nursing Council of New Zealand. Corporate sponsors include Virgin Blue, Virgin Atlantic, and MessageNet. Anna Dawson was supported by the Sir Robert Menzies Memorial Foundation Limited. Catherine Turner, Paul Hodges, and Simon Stewart are supported by the National Health and Medical Research Council of Australia.
PY - 2011/7
Y1 - 2011/7
N2 - Sick leave due to low back pain (LBP-SL) is costly and compromises workforce productivity. The fear-avoidance model asserts that maladaptive pain-related cognitions lead to avoidance and disuse, which can perpetuate ongoing pain. Staying home from work is an avoidant behavior, and hence pain-related psychological features may help explain LBP-SL. We examined the relative contribution of pain catastrophizing, fear of movement, and pain coping (active and passive) in LBP-SL in addition to pain characteristics and other psychosocial, occupational, general health, and demographic factors. Two-way interactions between age and gender and candidate exposures were also considered. Our sample comprised 2164 working nurses and midwives with low back pain in the preceding year. Binary logistic regression was performed on cross-sectional data by manual backward stepwise elimination of nonsignificant terms to generate a parsimonious multivariable model. From an extensive array of exposures assessed, fear of movement (women, odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.02-1.08; men, OR = 1.17, 95% CI 1.05-1.29), passive coping (OR = 1.07, 95% CI 1.04-1.11), pain severity (OR = 1.61, 95% CI 1.50-1.72), pain radiation (women, OR = 1.45, 95% CI 1.10-1.92; men, OR = 4.13, 95% CI 2.15-7.95), and manual handling frequency (OR = 1.03, 95% CI 1.01-1.05) increased the likelihood of LBP-SL in the preceding 12 months. Administrators and managers were less likely to report LBP-SL (OR = 0.44, 95% CI 0.27-0.71), and age had a protective effect in individuals in a married or de facto relationship (OR = 0.97, 95% CI 0.95-0.98). In summary, fear of movement, passive coping, frequent manual handling, and severe or radiating pain increase the likelihood of LBP-SL. Gender-specific responses to pain radiation and fear of movement are evident. The relative contribution of pain-related psychological features in sick leave due to low back pain is established in a large homogeneous worker cohort. Multidimensional preventive interventions are needed that address fear of movement and passive coping behaviors, promote effective pain management and optimize manual handling frequency. Crown
AB - Sick leave due to low back pain (LBP-SL) is costly and compromises workforce productivity. The fear-avoidance model asserts that maladaptive pain-related cognitions lead to avoidance and disuse, which can perpetuate ongoing pain. Staying home from work is an avoidant behavior, and hence pain-related psychological features may help explain LBP-SL. We examined the relative contribution of pain catastrophizing, fear of movement, and pain coping (active and passive) in LBP-SL in addition to pain characteristics and other psychosocial, occupational, general health, and demographic factors. Two-way interactions between age and gender and candidate exposures were also considered. Our sample comprised 2164 working nurses and midwives with low back pain in the preceding year. Binary logistic regression was performed on cross-sectional data by manual backward stepwise elimination of nonsignificant terms to generate a parsimonious multivariable model. From an extensive array of exposures assessed, fear of movement (women, odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.02-1.08; men, OR = 1.17, 95% CI 1.05-1.29), passive coping (OR = 1.07, 95% CI 1.04-1.11), pain severity (OR = 1.61, 95% CI 1.50-1.72), pain radiation (women, OR = 1.45, 95% CI 1.10-1.92; men, OR = 4.13, 95% CI 2.15-7.95), and manual handling frequency (OR = 1.03, 95% CI 1.01-1.05) increased the likelihood of LBP-SL in the preceding 12 months. Administrators and managers were less likely to report LBP-SL (OR = 0.44, 95% CI 0.27-0.71), and age had a protective effect in individuals in a married or de facto relationship (OR = 0.97, 95% CI 0.95-0.98). In summary, fear of movement, passive coping, frequent manual handling, and severe or radiating pain increase the likelihood of LBP-SL. Gender-specific responses to pain radiation and fear of movement are evident. The relative contribution of pain-related psychological features in sick leave due to low back pain is established in a large homogeneous worker cohort. Multidimensional preventive interventions are needed that address fear of movement and passive coping behaviors, promote effective pain management and optimize manual handling frequency. Crown
KW - Fear of movement
KW - Low back pain
KW - Manual handling
KW - Passive coping
KW - Psychosocial factors
KW - Sick leave
UR - http://www.scopus.com/inward/record.url?scp=79958715774&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2011.02.041
DO - 10.1016/j.pain.2011.02.041
M3 - Article
C2 - 21570184
AN - SCOPUS:79958715774
SN - 0304-3959
VL - 152
SP - 1517
EP - 1524
JO - Pain
JF - Pain
IS - 7
ER -