Abstract
Objective: To determine the extent to which coping strategies mediate chronic low back pain (CLBP) disability in patients presenting for physiotherapy.
Subjects: CLBP patients presenting for their first assessment at an outpatient physiotherapy department were used (N = 90; 60% male; M age = 41 yrs; SD ± 10).
Design: The mediating role of coping strategies was investigated after controlling for the influence of recorded demographics, healthcare variables and pain. Hierarchical multiple regression was employed with disability1 as the dependent variable. Independent variables were entered in three separate steps. Demographics (sex, age and socioeconomic status) were entered in Step one. Healthcare and Pain variables (leg pain, previous surgery, history of back pain and current pain intensity [VAS]) were entered in Step two. Three coping dimensions (Adaptive Coping, Maladaptive Coping and Efficacy of Pain Management), derived from a factor analysis of the Coping Strategies Questionnaire2, were entered in the final Step.
Results: Demographics accounted for 14% of the variance in disability [F (3, 86) = 4.81, P =. 004]. Healthcare and Pain variables accounted for an additional 17% of the variance [F (4, 82) = 5.11, P =. 001]. The three coping dimensions accounted for a further 6% of the variance [F (3, 79) = 2.71, P =. 05]. The model accounted for 38% of the variance in disability [F (10, 79) = 4.81, P =. 000].
Conclusion: Coping did mediate levels of CLBP disability. Moreover, disability is influenced more by Adaptive (Standardised β = −. 26, P =. 02) and Maladaptive (Standardised β =. 27, P =. 02) coping strategies than Efficacy of Pain Management (Standardised β =. 07, P > . 05).
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
References
1 Roland, M. and Morris, R. (1983). A study of the natural history of back pain. Part I. Development of a reliable and sensitive measure of disability in low-back pain. Spine, 8 2), 141–144. Google Scholar
2 Rosenstiel, A. K. and Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment. Pain, 17, 33–44. Google Scholar
