Self-Management Among Adults with Chronic Low Back Pain: A Causal Model

Authors

  • Benyapa Prompuk RN, PhD Candidate, Faculty of Nursing, Chiang Mai University, Thailand
  • Wanchai Lertwatthanawilat RN, PhD, Associate Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • Tipaporn Wonghongkul RN, PhD, Associate Professor, Faculty of Nursing,Chiang Mai University, Thailand
  • Khanokporn Sucamvang RN, PhD, Assistant Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • Torphong Bunmaprasert MD, Associate Professor, Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand

Keywords:

causal model, chronic low back pain, Factors affecting self-management, Low back pain, Self-management

Abstract

               Chronic low back pain is a common musculoskeletal problem and requires self-management among adults to carry out an active and emotionally satisfying life. To support self-management, it is necessary to understand how various factors work to influence this. The objective of this study was to develop a causal model of self-management among adults with chronic low back pain. A total of 174 Thai adults with chronic low back pain aged between 30 – 60 years were randomly selected by a multi-stage sampling method from four hospitals in the northern region of Thailand. Data were collected via the following instruments: The Demographic Data Form, Self-Management Scale, Modified Self-Efficacy for Chronic Low Back Pain Management Scale, Low Back Pain Knowledge Questionnaire, Modified Barthel’s Activity of Daily Living Index, Chula Activity of Daily Living Index, Social Support Questionnaire, and Belief in Treatment Effectiveness Scale. Data were analyzed by descriptive statistics, Pearson’s product moment correlation, and path analysis.
             The results revealed that overall self-management was at a moderate level. A causal model of self-management fitted with data, and was able to explain 33.00 % of the variance in self-management by four factors. These factors, self-efficacy, social support, low back pain knowledge, and belief in treatment effectiveness directly affected self-management. Social support both directly and indirectly affected self-management through self-efficacy and belief in treatment effectiveness. These results indicate that nurses can use the four factors to conduct appropriate interventions for promoting self-management among adults with chronic low back pain.

Author Biography

Tipaporn Wonghongkul, RN, PhD, Associate Professor, Faculty of Nursing,Chiang Mai University, Thailand

 

 

References

1. American College of Physicians. Noninvasive treatment for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians [Internet]. 2017 [cited 2017 Aug 22]. Available from: https://annals.org/aim/fullarticle/2603228/noninvasive -treatments-acute-subacute-chronic-low-back-pain-clinical-practice

2. Institute of Health Economics. Guideline for the Evidence-informed primary care management of low back pain. 3rd ed. c2015 [cited 2016 Jun 8]. Available from: https://www. topalbertadoctors.org/cpgs/?sid=65&cpg_cats=90.

3. Salvetti MG, Pimenta CM, Braga PE, Correa CF. Disability related to chronic low back pain: prevalence and associated factors. Revista da Escola de Enfermagem da USP 2012;46 (Esp.): 16-23.

4. Nekovarova T, Yamamotova A, Vales K, Stuchlik A, Fricova J, Rokyta R. Common mechanisms of pain and depression: are antidepressants also analgesics? Behav Neurosci 2014;8(99):1-12.

5. Moore JE, Tollison SJ. Psychosocial factors in low back pain management. 2014 [cited 2016 Jul 10]. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ 9781118453940.fmatter/summary

6. De Moraes Vieira EB, de Goes Salvetti M, Damiani LP, de Mattos Pimenta CA. Self-efficacy and fear avoidance beliefs in chronic low back pain patients: coexistence and associated factors. Pain Manag Nurs 2013;13:1-10.

7. Mathew J, Singh SB, Garis S, Diwan AD. Backing up the stories: the psychological and social costs of chronic low back pain. Int J Spine Surg 2013;7(1):e29-38.

8. Keawdungdee P, Puntumetakul R, Siritaratiwat W, Boonprakop Y, Wanpen S, Rithmark P, Thavornpitak Y. The prevalence and association factors of working posture of low back pain in the textile occupation (fishing net) in Khon Kaen Province. SMJ 2011;26(4): 317-24.

9. Harirforoosh S, Asghar W, Jamali F. Adverse effects of nonsteroidal anti-inflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. JPP 2013;16(5): 821-47.

10. Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA. Rothman-simeone: the spine. 6th ed. Philadelphia: Elsevier Saunders; 2011.

11. Norris CM. Back stability integrating science and therapy. 3rd ed. USA: Human Kinetics; 2011.

12. Xu Y, Toobert D, Pan W, Whitmer K. Factors influencing self-management in Chinese people with type 2 diabetes. Res Nurs Health 2008; 31:613-25.

13. Zhong X, Tanasugarn C, Fisher EB, Krudsood S, Nityasuddhi D. Awareness and practices of self-management and influence factors among individuals with type 2 diabetes in Urban Community setting in Anhui Province, China. Southeast Asian J Trop Med Public Health 2011;42(1):184-96.

14. Li H, Jiang YF, Lin CC. Factors associated with self-management by people undergoing hemodialysis: a descriptive study. Int J Nurs Stud 2013;13:1-9.

15. Tiet Hanh DT. An investigation of factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam. c2012 [cited 2015 October 9]. Available from: https://eprints.qut.edu.au/62188/1/ Tiet_Hanh_Dao_Tran_Thesis.pdf

16. Sritarapipat P, Pothiban L, Panuthai S, Lumlertgul D, Nanasilp P. Causal model of elderly Thais’ self-Management behaviors of pre-dialysis chronic kidney disease. Pacific Rim Int J Nurs Res 2012;16(4):277-93.

17. Li CC. The development and testing of a self-management behavior model for patients with chronic obstructive pulmonary disease [dissertation]. Hong Kong: Chinese University of Hong Kong; 2015.

18. Kawi J. Predictors of self-management for chronic low back pain. Appl Nurs Res 2014; 27:206-12.


19. Kordasiabi MC, Akhlaghi M, Baghianimoghadam MH, Morowatisharifabad MA, Askarishahi M, Enjezab B, et al. Self-management behaviors in rheumatoid arthritis patients and associated factors in Tehran. Glob J Health Sci 2016;8(3):156-67.

20. Lorig K. Self-management of chronic illness: a model for the future. Generations 1993;17(3):11-14.

21. Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanism. Ann Behav Med. 2003; 26(1):1-7.

22. Schulz PJ, Rubinell S, Zufferey MC, HartungU. Coping with chronic low back pain: designing and testing the online tool ONESELF. JCMC 2010;15:625-45.

23. Nattharom, M. Pain management model for patients with low back pain at home [Master thesis]. Songkla, Thailand: Prince of Songkla University; 2003.

24. Crowe M, Whitehead L, Gagan MJ, Baxter D, Panckhurst A. Self-management and chronic low back pain: a qualitative study. JAN 2010;66(7):1478-86.

25. Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.

26. Disler RT, Gallagher RD, Davidson PM. Factors influencing self-management in chronic obstructive pulmonary disease: a integrative review. Int J Nurs Stud 2012;49:230-42.
27. Jitapunkul S, Kamolratanakul P, Chandraprasert S, Bunnag S. Disability among Thai elderly living in Klong Toey slum. J Med Assoc Thai 1994;77(5):231-8.

28. Maciel SC, Jennings F, Jones A, Natour J. The development and validation of a Low Back Pain Knowledge Questionnaire- LKQ. Clinics (Sao Paulo) 2009;64(12):1167-75.

29. House, J. S. Work stress and social support. Reading, MA: Addison-Wesley; 1981.

30. World Health Organization (WHO). The International Statistical Classification of Disease and Related Health Problems 10th revision, version for 2010 (ICD-10). France: Eastern/Jouve; 2010.

31. Kellar SP, Kelvin EA. Munro’s statistic methods for health care research. 6th ed. Philadelphia: Wolters Kluwer Health Lippincott & Wilkins; 2013.

32. Hair Jr JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. The United States of America: Person Prentice Hall; 2010.

33. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.

34. DeVellis RF. Scale development theory and applications. 3rd ed. Thousand Oake: Sage Publications; 2012.

35. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. 4rd ed. New York: Springer Publishing Company; 2010.

36. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993;46(12): 1417-32.

37. Stanford University. Chronic Disease Self-management Program Questionnaire Code Book. c2007 [cited 2014 Jan 15]. Available from: https://www.patienteducation. standford.edu

38. Lortrakul N. Social support and health behaviors among the elderly with coronary artery disease [Master Thesis]. Chiang Mai, Thailand: Chiang Mai University; 2000.

39. Tabachnick BG, Fidell LS. Pearson new international edition: using multivariate statistics. 6th ed. The United States of America: Pearson Education, Inc; 2014.

40. Main CJ, Foster N, Buchbinder R. How important are back pain belief and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 2010;24:205-17.

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Published

2018-06-07

How to Cite

1.
Prompuk B, Lertwatthanawilat W, Wonghongkul T, Sucamvang K, Bunmaprasert T. Self-Management Among Adults with Chronic Low Back Pain: A Causal Model. PRIJNR [Internet]. 2018 Jun. 7 [cited 2024 Nov. 14];22(3):223-36. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/91486

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Original paper