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    Is the psychosocial profile of people with low back pain seeking care in Danish primary care different from those in secondary care?

    Access Status
    Fulltext not available
    Authors
    Morsø, L.
    Kent, Peter
    Albert, H.
    Manniche, C.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Morsø, L. and Kent, P. and Albert, H. and Manniche, C. 2013. Is the psychosocial profile of people with low back pain seeking care in Danish primary care different from those in secondary care? Manual Therapy. 18 (1): pp. 54-59.
    Source Title
    Manual Therapy
    DOI
    10.1016/j.math.2012.07.002
    ISSN
    1356-689X
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/54781
    Collection
    • Curtin Research Publications
    Abstract

    Differences between the psychosocial risk factors of low back pain (LBP) patients in primary and secondary care are under-investigated. Similarly, differences in the psychosocial profile of people classified into STarT Back Screening Tool (SBT) subgroups in primary and secondary care settings have not been investigated. The aim of the study was to determine: (1) if movement-related fear, catastrophisation, anxiety and/or depression in LBP patients are different between primary and secondary care settings, and (2) if those differences are retained when stratified by SBT subgroup. This study was a cross-sectional comparison of LBP patients in Danish primary settings (405 general practitioner or physiotherapy patients) and a secondary care setting (311 outpatient spine centre patients). Psychosocial factors were measured with the Roland Morris Disability Questionnaire, the Tampa Scale of Kinesiophobia, the Coping Strategies Questionnaire (catastrophisation subscale), and the Hospital Anxiety and Depression Scale. There were significantly higher scores in secondary care for movement-related fear (1.3 points (95%CI .1-2.5) p = .030) and catastrophisation (2.0 (95%CI 1.0-3.0) p < .000), lower scores on anxiety (-1.0 (95%CI -1.0-2.0) p < .000) but no difference for depression. These differences in psychosocial scores were broadly retained when stratified by SBT subgroup. However, questionnaire-specific reported thresholds for important difference scores indicate the size of these differences between the care settings were unlikely to be clinically important from a patient perspective. Longitudinal studies are required to investigate the predictive ability of SBT in secondary care settings and whether treatment targeted to SBT subgroups is effective in secondary care.

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