DETERMINATION OF EMOTIONAL AND BEHAVIORAL FACTORS ASSOCIATED WITH PAIN SEVERITY IN PATIENTS WITH CHRONIC LOW BACK PAIN

Year 2024, Volume: 25 Issue: 2, 168 - 174, 29.04.2024

Mehmet Duray , Merve Karapınar

https://doi.org/10.18229/kocatepetip.1276093

Abstract

OBJECTIVE: The primary aim of the study was to determine which emotional and behavioral factors affect the pain severity and to what extent in patients with chronic low back pain (LBP).
MATERIAL AND METHODS: One hundred and seventy-eight patients with LBP participated in the cross-sectional study. The primary outcome was the Visual Analog Scale (VAS) evaluated the pain severity during rest (VASrest) and activity (VASact). Secondary outcomes included the Pain Beliefs Questionnaire (PBQ), The Pain Coping Questionnaire (PCQ) and The Fear-Avoidance Beliefs Questionnaire (FABQ).
RESULTS: While PBQ scores increased, VASrest and VASact scores decreased significantly (p< 0.05). There was a positive and significant correlation between VASrest and only Medical Remedies Subparameter of PCQ(p=0.008), and between VASactivity and only Helpless Subparameter of PCQ (p<0.05). VASrest and VASact had positive and significant associations with FABQ scores (p< 0.05). The results of the regression analysis showed that pain-related psychologic beliefs are the main determinants of VASrest(p=0.014) and VASact (p=0.006). Pain related organic beliefs had a significant but lower effect on VASrest (p=0.019) and VASact (p=0.031). It was observed that seeking a medical remedy for pain at rest had a significant effect on reducing the VAS scores(p=0.024).
CONCLUSIONS: Inadequacies in the management of negative beliefs associated with pain contribute to the exacerbation of pain even at rest. However, neither fear avoidance behavior nor coping strategies except medical remedies developed for pain at rest do not reduce pain severity.

Keywords

Low back pain, Beliefs, Coping strategies, Fear avoidance, Psychosocial factors

KRONİK BEL AĞRILI HASTALARDA AĞRI ŞİDDETİ İLE İLİŞKİLİ EMOSYONEL VE DAVRANIŞSAL FAKTÖRLERİN BELİRLENMESİ

Abstract

AMAÇ: Çalışmamızın amacı, kronik bel ağrısı olan hastaların emosyonel ve davranışsal faktörlerin hastaların ağrı şiddetini ne ölçüde etkilediğini belirlemektir.
GEREÇ VE YÖNTEM: Kesitsel tipteki araştırmamıza kronik bel ağrısı olan yüz yetmiş-sekiz hasta dahil edildi. Birincil değerlendirme parametrelerimiz dinlenme ve aktivite sırasındaki ağrı şiddetini değerlendiren Görsel Analgol Sklası (GASdinlenme, GASaktivite) idi. İkincil değerlendirme parametrelerimiz ise Ağrı İnançları Anketi (AİA), Ağrıyla Başa Çıkma Ölçeği (ABÇÖ) ve Korku-Kaçınma İnançları Anketidir (KKİA).
BULGULAR: Hastaların Ağrı İnaçları Anketi puanları arttıkça, dinlenme (GASdinlenme)ve aktivite (GASaktivite) sırasında ağrı şiddedileri azaldı (p<0,05). GASdinlenme ile ABÇÖ’nin sadece Tıbbi Çare Arama alt parametresi arasında (p=0,008), GASaktivite ile ABÇÖ’nin sadece Çaresizlik altparametresi arasında pozitif ve anlamlı bir korelasyon vardı (p<0,05). GASaktivite ve GASdinlenme ile KKİA puanları arasında pozitif ve anlamlı ilişkili olduğu görüldü (p<0,05). Regresyon analizi sonuçları, ağrı ile ilgili psikolojik inançların GASdinlenme (p=0,014) ve GASaktivite (p=0,006) ‘nin temel belirleyicisi olduğunu göstermiştir. Ağrı ile ilgili organik inançlar, GASdinlenme (p=0,019) ve GASaktivite (p=0,031) üzerinde anlamlı ancak daha düşük etkiye sahip olduğu gözlemlendi. İstirahat halinde ağrı için ilaç almanın GAS pualarını düşürmede anlamlı etkisi olduğu görüldü (p=0,024).
SONUÇ: Ağrı ile ilişkili olumsuz inançların yönetimindeki yetersizlikler, istirahatte bile ağrının şiddetlenmesine katkıda bulunmaktadır. Ancak ağrı için geliştirilen tıbbi tedaviler dışında ne korkudan kaçınma davranışı ne de ağrı ile başa çıkma stratejileri ağrı şiddetini azaltmamaktadır.

Keywords

Bel ağrısı, İnançlar, Başa çıkma stratejileri, Korkudan kaçınma, Psikososyal faktörler.

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