Illness beliefs and treatment beliefs as predictors of short-term and medium-term outcome in chronic back pain.

Abstract

OBJECTIVE: Patients' illness beliefs were shown to be more relevant than other psychosocial factors of influence for predicting outcome in back pain in primary care. The aim of this study was to determine whether illness beliefs and beliefs about rehabilitation are predictors of functioning, pain intensity, and coping with pain after rehabilitation in a population with longstanding chronic back pain. DESIGN AND PATIENTS: The study included 110 patients with longstanding chronic back pain in a longitudinal study design with 3 measurement points (before rehabilitation, end of rehabilitation, and 6 months follow-up). METHODS: Hierarchical multiple regression analyses were conducted to test the relative contribution of illness beliefs and beliefs about rehabilitation to the rehabilitation outcomes while adjusting for baseline values of outcome measures, mental health, sociodemographic, and illness-related variables. RESULTS: Illness beliefs and beliefs about rehabilitation made a significant contribution to the prediction of rehabilitation outcomes. In the short and medium term, incremental variance for coping with pain was as much as 13%, for functioning up to 14%, and for pain intensity between 6% and 9%. CONCLUSION: Further studies should be conducted as a confirmatory test of our preliminary results and to test the relative relevance of these constructs compared with other yellow flags for chronic patient samples.