Academic journal article Journal of Cultural Diversity

Low Back Pain Beliefs and Their Relationships with Low Back Pain-Related Disability in Nurses Working in Mainland China and in Australia

Academic journal article Journal of Cultural Diversity

Low Back Pain Beliefs and Their Relationships with Low Back Pain-Related Disability in Nurses Working in Mainland China and in Australia

Article excerpt

Abstract: Beliefs held about low back pain (LBP) can influence treatment outcomes and the development of LBP-related disability. Beliefs are shaped by cultural norms but few cross-cultural studies have been done. This cross-sectional study investigated the back pain beliefs and their associationswith disabilityin 109 Chinese nurses and 165 Australian Caucasian nur ses. Chinese nurses held more pessimistic views about the consequences of LBP than the Australian and those with LBP held higher level of fear avoidance beliefsand had higher disability than the Australian nurses with LBP. In both groups, more negativeback pain beliefswere significantly associated withhigher disability.

Key Words: Australia; Beliefs; China; Disability; Low Back Pain; Nurses

There is substantial healthcare cost associated with the treatment of low back pain (LBP) without evidence of commensurate reduction in LBP-related disability levels (Deyo, Mirza, Turner, & Martin, 2009). The upward trend of direct and indirect healthcare cost have been attributed to the focus on the structural or patho-anatomical causes of pain; resulting in a biomedical treatment orientation which typically comprise of radiological imaging and advice regarding restriction of physical activity and if it is symptom provoking, absence from work (Bishop, Foster, Thomas, & Hay, 2008; Deyo et al., 2009; Pincus et al., 2007). Evidence that personal beliefs held about back pain can influence treatment outcomes as well as playing a role in the development of chronic low back disorders and disability (Briggs et al., 2010; Buchbinder, Jolley, & Wyatt, 2001; Coudeyre et al., 2006; Urquhart et al., 2008) lends strong support for a biopsychosocial model of care for treatment of LBP (Domenecn, Sanchez-Zuriaga, Segura-Orti, Espejo-Tort, & Lison, 2011).

There existvarious types of back pain beliefs.First, there are beliefs about the inevitable consequences of LBP (George et al., 2009; Symonds, Burton, Tillotson, & Main, 1996; Urquhart et al., 2008) and second, fearavoidance beliefs (FABs) (Dawson, Schlüter, Hodges, Stewart, & Turner, 2011; Waddell, Newton, Henderson, Somerville, & Main, 1993). The role of these beliefs has been expounded by Main and associates (Main, Foster, & Buchbinder, 2010), who highlighted that more negative beliefs can contribute to tne perception of pain, affect treatment outcomes, lead to chronicity and consequently, pain-related disability (Crombez, Vlaeyen, Heuts, & et, 1999; Main et al., 2010; Sions & Hicks, 2011; Waddell et al., 1993).

A third type of beliefs are those held by healthcare practitioners and these are known to influence the beliefs of the patients they treat(Darlow et al., 2012; Linton, Vlaeyen, & Ostelo, 2002; Vlaeyen & Linton, 2006), the treatment advice given (Coudeyre et al., 2006; Darlow et al., 2012; Houben et al., 2004; Poiraudeau et al., 2006) and consequently, treatment outcomes (Darlow et al., 2012; Main et al., 2010). Hence, the investigation of LBP beliefs held by healthcare providers has been the focus of recent research (Tan et al., 2014)but most studies on pain beliefs have been almost exclusively investigated in developed western countries(Linton et al., 2002; Rainville, Bagnall, & Phalen, 1995).

The relationship between greater LBP-related disability and more negative back pain beliefs has been reported in several studies, but these were mainly in western cohorts (Briggs et al., 2010; Sions & Hicks, 2011; Urquhart et al., 2008; Waddell et al., 1993). Culturalnorms, organizational, professional and social settings and personal experience of LBP have been purported to influence back pain beliefs (Briggs et al., 2013; Burnett et al., 2009; Main et al., 2010; Main & Waddell, 2004; Tan et al., 2014). However, little is known if the above factors influence the relationship between back pain beliefs and LBP-related disability.

Nurses, amongst the healthcare professionals group, are known to have an increased risk of developing LBPQune & Cho, 2011; Yip, 2004)due to the nature of their duties and work-associated psychological stress (D. …

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