An investigation of psychosocial factors in back pain
The thesis describes a number of qualitative and quantitative studies in the
investigation of psychosocial risk factors for back pain and absenteeism. A study of
information processing 'biases' was completed comparing three diagnostically
different chronic pain groups. Back pain and arthritis patients devote greater
processing resources towards illness information than healthy controls. Development
of a pain schema is suggested to be related to the personal meaning of pain.
A further cross sectional investigation of psychosocial factors associated with back
pain in a care assistant population was conducted. Work factors including perception
of physical strain and job satisfaction; psychological factors such as pain beliefs,
emotionality and family pain history and measures of pain in the last month were
assessed. Results found that people reporting back pain had significantly lower job
satisfaction, were older and worked significantly longer as care assistants than those
reporting a mixture of pain symptoms. Reporting of general pain symptoms and
absenteeism was also investigated.
This was followed by a longitudinal study of care workers at risk of back pain.
Negative emotionality and job satisfaction were identified in a logistic regression as
being significant predictors of back pain at six months. High negative emotionality
scores at baseline were significantly correlated with high numbers of pain symptoms at
follow-up. Difficulties in conducting longitudinal risk research are discussed.
The development of the pain schema was investigated by distributing word stem tasks
to a variable pain population at baseline and follow-up. People reporting three or
more pain symptoms and high pain frequencies were more likely to give higher pain
sensory completions. At follow-up, as number of pain symptoms increased over six
months so did the number of pain affective responses.
The final study was a qualitative investigation of the meaning of back pain in thirty
two care assistants using semi structured interviews. Findings suggest that patients
delay seeking treatment when they perceive high susceptibility of back pain in the
working environment, low severity of back pain and few benefits of treatment. Such
findings are further discussed within the principals of the Health Belief Model (Becker,