Health Literacy and Fear Avoidance Beliefs Among Women with Chronic Low Back Pain

Abstract

Purpose Low back pain is considered a major health issue universally. LBP patients may avoid certain activities due to their fear avoidance behavior. Health literacy has a huge influence on the health programs and service delivery models mainly in managing chronic low back pain. The aim of this study was to examine the relation between low back pain disability, fear avoidance beliefs’ and health literacy.

Materials and Methods 227 female low back pain patients of age between 20 and 55 years were analyzed. Disability, fear avoidance, and health literacy were subjectively assessed using the Oswestry Disability Index (ODI), the Fear Avoidance Beliefs’ Questionnaire (FABQ), and the Newest Vital Sign (NVS), respectively. Pearson correlation was used to determine the association between Disability, fear avoidance beliefs’ and health literacy.

Results The high disability group had significantly poor beliefs related to physical activity (FAB-PA) as well as work (FAB-W). Low disability group had adequate literacy compared to those with the high disability. Greater disability was associated with higher levels of fear avoidance beliefs related to physical activity(r=0.4; p−0.00) and work (r=0.3; p−0.00) and was negatively correlated with health literacy (r=− 0.4; p≤0.01).

Conclusion The study findings showed that moderate relationship exists between disability and elevated fear-avoidance beliefs and patients with limited health literacy may have difficulty in self-management of back pain further leading to chronic disability. A multidisciplinary approach focusing on these aspects while assessing disability due to low back pain is needed.

Zusammenfassung

Ziel Schmerzen im unteren Rückenbereich werden allgemein als bedeutendes Gesundheitsproblem angesehen. Patienten mit Schmerzen im unteren Rückenbereich sollten wegen ihres Angst-Vermeidungsverhaltens bestimmte Tätigkeiten vermeiden. Gesundheitskompetenz hat vor allem bei der Behandlung chronischer lumbaler Rückenschmerzen einen enormen Einfluss auf die Gesundheitsprogramme und Dienstleistungsmodelle. Ziel dieser Studie war es, die Beziehung zwischen durch Schmerzen im unteren Rückenbereich verursachter Behinderung, Angstvermeidungsüberzeugungen und Gesundheitskompetenz zu untersuchen.

Materialien und Methoden Es wurden 227 Patientinnen mit lumbalen Rückenschmerzen im Alter zwischen 20 und 55 Jahren untersucht. Behinderung, Angstvermeidung und Gesundheitskompetenz wurden subjektiv jeweils mit dem Oswestry Disability Index (ODI), dem Fear Avoidance Beliefs’ Questionnaire (FABQ) und dem Newest Vital Sign (NVS) beurteilt. Zur Bestimmung des Zusammenhangs zwischen Behinderung, Angstvermeidung und Gesundheitskompetenz wurde die Pearson-Korrelation verwendet.

Ergebnisse Die Gruppe mit hoher Behinderung hatte signifikant schwache Überzeugungen in Bezug auf körperliche Aktivität (FAB-PA) sowie Arbeit (FAB -W). Die Gruppe mit niedriger Behinderung hatte angemessene Gesundheitskompetenz im Vergleich zur Gruppe mit hoher Behinderung. Größere Behinderung war mit einem höheren Grad an Angstvermeidungsüberzeugungen im Zusammenhang mit körperlicher Aktivität (r=0,4; p−0,00) und Arbeit (r=0,3; p−0,00) assoziiert und negativ mit der Gesundheitskompetenz korreliert (r=− 0,4; p≤0,01).

Fazit Die Ergebnisse der Untersuchung zeigten, dass zwischen Behinderung und erhöhtem Angst-Vermeidungsglauben ein leichter Zusammenhang besteht und dass Patienten mit beschränkter Gesundheitskompetenz Schwierigkeiten bei der Selbstbehandlung von Rückenschmerzen haben können, was letztlich zu chronischer Behinderung führt. Es wird ein multidisziplinärer Ansatz benötigt, der diese Aspekte fokussiert und dabei Behinderung aufgrund von Schmerzen im unteren Rückenbereich abschätzt.

Key words

health information - adequate literacy - back beliefs

Schlüsselwörter

Gesundheitsinformation - Uberzeugungen zu Ruckenschmerzen - angemessene Gesundheitskompetenz

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