Predicting factors of Self-management Among Persons with Chronic Back Pain


  • Rujadhorn Indratula Faculty of Nursing, Chiang Mai University
  • Wanchai Lertwatthanawilat Associate Professor, Faculty of Nursing, Chiang Mai University
  • Benyapa Promphuk Instructor Boromarajonani College of Nursing Buddhachinaraj
  • Apichat Kardosod Instructor, Faculty of Nursing, Chiang Mai University
  • Wilailak Womgcharoen Registered Nurse, Maharaj Nakorn Chiang Mai Hospital


Self-management, Persons with Chronic Back Pain, Predicting factors


Chronic back pain is an important health problem in adult and older adult which severely affect patient’s physical, emotional, economic, and also their quality of life.  Therefore, self-management is very important among these people.  This study aimed to determine predictive factors of social support, self-efficacy, and health literacy on self-management among persons with chronic back pain.  Four hundred persons with chronic back pain were purposively selected from the orthopedic outpatient department, the university hospital in the northern part of Thailand. Data were collected by four assessment tools, which consisted of five parts: 1) demographic data form, 2) Self-Management Scale 3) Social Support scale 4) Self-Efficacy for Chronic Back Pain Management Scale and 5) Health literacy Scale. Reliability of Social Support Scale yielded Cronbach’s Alpha coefficient of .81, .92, .80, .80, respectively.  Data were analyzed using descriptive statistics and logistic regression.

     The results revealed that 62 percent of samples had a self-management scores at a high level (Mean= 72.72, SD = 9.90).  The social support, heath literacy, age, male gender, and duration of chronic back pain can explain the self-management among persons with chronic back pain for 35.6% (p < .001). The results indicated that nurses can use these significant factors to enhance self-management. among persons with chronic back pain. Development of a program and media to improve health literacy based on these significant factors to improve self-management among persons with chronic back pain are suggested.


Download data is not yet available.

Author Biography

Rujadhorn Indratula, Faculty of Nursing, Chiang Mai University

Instructor Dr.Rujadhorn Indratula


Surgical Nursing, Faculty of Nursing, Chiang Mai University


American College of Physicians. (2017). Noninvasive treatment for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Retrieved from

Ardkhitkarn, S., Pothiban, L., Lasuka, D. (2013). Self –Management Behaviors and Predicting Factors in Elders with End Stage Renal Disease Undergoing Continuous Ambulatory Peritoneal Dialysis. Nursing Journal, 40(Supplement), 22-32.

Bandura A. (1997). Self-efficacy: the exercise of control. New York: Freeman.

Boonprasit, S., Somanusorn, S., & Sumngern, C. (2017). Factors related to self-management for controlling plasma glucose in uncontrolled diabetes elderly. Journal of Health and Nursing Research, 33(3), 70-80. Retrieved from

Geboers, B., de Winter, A. F., Spoorenberg, S. L., Wynia, K., & Reijneveld, S. A. (2016). The association between health literacy and self-management abilities in adults aged 75 and older, and its moderators. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation, 25(11), 2869–2877.

Harirforoosh, S., Asghar, W., & Jamali, F. (2013). Adverse effects of nonsteroidal anti-inflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. The Journal of Pharmacy Practice, 16(5), 821-47.

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

Institute of Health Economics. (2015). Guideline for the Evidence-informed primary care management of low back pain. 3rd ed. Retrieved from http://www.

Ishikawa, H., Takeuchi, T., & Yano, E. (2008). Measuring Functional, Communicative, and Critical Health Literacy Among Diabetic Patients. Diabetes Care, 31(5), 874-877.

Jandeekaewsakul, P., Watthayu, N., Suwonnaroop, N. (2018). Factors Predicting Self-Management Behavior among Patients with Uncontrolled Essential Hypertension. Journal of Nursing Science, 36(1), 31-43.

Kawi, J. (2014) Predictors of self-management for chronic low back pain. Applied Nursing Research, 27, 206-212.

Krejcie, R. V., & Morgan, D. W. (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement, 30(3), 607-610.

Lee, J. E., Han, H. R., Song, H., Kim, J., Kim, K. B., Ryn, J. P., et al. (2010). Correlates of self-care behaviors for managing hypertension among Korean Americans: a questionnaire survey. International Journal of Nursing Studies, 47(4), 411-17.

Li, H., Jiang, Y. F., & Lin, C. C. (2013). Factors associated with self-management by people undergoing hemodialysis: a descriptive study. The International Journal of Nursing Studies, 13,1-9.

Lorig, K. R., & Holman, H. R. (2003). Self-management education: history, definition, outcomes, and mechanism. Annals of Behavioral Medicine, 26(1):1-7.

Lortrakul, N. (2000). Social Support and Health Promoting Behaviors among the Elderly with Coronary Artery Disease. Chiang Mai: Faculty of Nursing, Chiang Mai University. (In Thai).

Maneesriwongkul, W. (2013). Needs Assessment among People Living with HIV and Receiving Antiretroviral Therapy Medication.: Bangkok: Faculty of Medicine Ramathibodi Hospital, Mahidol University (In Thai).

Medical Records and Statistics Section, Maharaj Nakorn Chiang Mai Hospital. (2020). Outpatient Statistics A.D. 2019. Personal contact on June, 2020.

Moore, J. E., & Tollison, S. J. (2014). Psychosocial factors in low back pain management. Retrieved from fmatter/summary

Noppakraw, J., Chintanawat, R., & Khampolsiri, T. (2020). Health Literacy and Self-Management in Older Persons with Type 2 Diabetes Mellitus. Nursing Journal, 47(2), 251-261.

Nutbeam, D. (2000). Health Literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267.

Polit, D., & Beck, C. (2016). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Prompuk, B., Lertwatthanawilat, W., Wonghongkul, T., Sucamvang, K., & Bunmaprasert, T. (2018). Self-Management Among Adults with Chronic Low Back Pain: A Causal Model. The Pacific Rim International Journal of Nursing Research, 22(3):223-236. Retrieved from:

Strategy and Planning Division. (2020). Health Illness Summary Report A.D. 2019. Retrieved from

Sritarapipat, P., Pothiban, L., Panuthai, S., Lumlertgul, D., & Nanasilp, P. (2012). Causal model of elderly Thais’ self-Management behaviors of pre-dialysis chronic kidney disease. The Pacific Rim International Journal of Nursing Research, 16(4), 277-293.

Sung, P. S., Zipple J. T., Danial, P. (2017). Gender differences in asymmetrical limb support patterns between subjects with and without recurrent low back pain. Human Movement Science, 52, 36-44. doi: 10.1016/j.humov.2017.01.002.

Xu, Y., Toobert, D., Pan, W., Whitmer, K. (2008). Factors influencing self-management in Chinese people with type 2 diabetes. Research in Nursing and Health, 31, 613-625.