from a blog by David DePaolo: Researchers principally from University of Zurich in Switzerland conducted a review of previous studies and found that two psychological phenomena – catastrophizing and fear-avoidance beliefs – are associated with return to work and levels of pain among patients with lower back pain. Catastrophizing is essentially a thinking pattern that elevates perceptions of problems to catastrophic levels. Fear avoidance is refraining from engaging in behaviors out of concern that it will increase pain. There are two common methods used to determine a patient’s level of fear avoidance. A team of researchers led by Gordon Waddell, a professor at Glasgow, Scotland’s Western Infirmary, created a fear-avoidance belief questionnaire in 1993 that creates a number score. The questionnaire asks patients to agree or disagree based on a numbered scale with statements such as I should not do physical activities which make my pain worse and my work might harm my back. The Tampa Scale of Kinesiophobia, developed in 1991, is structured in a similar way and asks comparable questions to produce a score. The score a patient gets based on those responses, according to the University of Zurich researchers, is associated with the outcomes patients had. Several studies included in the review found higher pain levels and fewer patients returning to work when they had higher scores. When patients went through interventions targeting those problems, they had better outcomes. A series of studies from the Workers Compensation Research Institute bolstered the evidence supporting that theory in June. The studies, which examined predictors of worker outcomes in eight states, surveyed more than 3,000 workers in those states. When asked whether they feared being fired because of their injury, 52% said they strongly disagreed, 9% somewhat disagreed, 12% somewhat agreed and 27% said they strongly agreed. The survey was conducted in 2013, and the participants were all injured in 2010, meaning they had been in the workers’ compensation system for at least three years. Of those who said they strongly agreed that they might be fired because of their work injury, 21% weren’t working at the time of the interview. For those who strongly or somewhat disagreed, the number was 10%. Further, the disability of those who strongly agreed lasted an average of 13 weeks, compared with nine weeks among those who disagreed that their injury might lead to being fired.
Posted on: Mon, 24 Nov 2014 18:17:46 +0000
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