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Low back pain patients in primary care: Subgroups based on the multidimensional pain inventory

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Abstract

Classification of patients into homogeneous subgroups is an important objective in primary care management of low back pain patients. The purpose of this studyis to (a) identify and describe cluster profiles based on self-reported multidimensional pain inventory Scale (MPI) scores among subacute and chronic nonspecific low back pain patients; (b) describe characteristics of the clusters in relation to disability, life satisfaction, functional self-efficacy, and exercise self-efficacy; and (c) compare grouping by clusters based on self-reported MPI scores with grouping by symptom duration. Eighty-eight individuals participated. These had a median lower back pain duration of 7 months (range 1 to 144 months). Three clusters were identified; these were labeled interpersonally distressed, adaptive copers, and dysfunctional. The clusters differed significantly in disability and functional self-efficacy scores, but not in life satisfaction and exercise self-efficacy scores. The results of this study in a primary care setting are discussed in relation to previous results in pain clinic settings.

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References

  • Aldenderfer, M., & Blashfield, R. (1984).Cluster analysis. (Vol. 44). Newbury Park: Sage.

  • Bergström, G., Jensen, I., Bodin, L., Linton, S., Nygren, L.,&Carlsson, S. (1998). Reliability and factor structure of the Multidimensional Pain Inventory—Swedish Language Version (MPI-S).Pain, 75, 101–110.

    Article  PubMed  Google Scholar 

  • Bergström, K., Jensen, I., Linton, S., & Nygren, A. (1999). A psychometric evaluation of the Swedish version of the Multidimensional Pain Inventory (MPI-S):A gender differentiated evaluation.European Journal of Pain, 3, 261–273.

    Article  PubMed  Google Scholar 

  • Carlsson, S., Bergström, G., & Jensen, I. (1994). The Multidimensional Pain Inventory:A Swedish version. Gothenburg, Sweden: Department of Psychology, University of Gothenburg.

  • Cherkin, D., Deyo, R., Street, J., & Barlow, W. (1996). Predicting poor outcomes for back pain seen in primary care using patients’ own criteria.Spine, 21, 2900–2907.

    Article  PubMed  Google Scholar 

  • Chibnall, J., & Tait, R. (1990). The Quality of Life Scale: A preliminary study with chronic pain patients.Psychology and Health, 4, 283–292.

    Article  Google Scholar 

  • Croft, P., Macfarlane, G., Papageorgiou, A., Thomas, E., & Silman, A. (1998). Outcome of low back pain in general practice: A prospective study.British Medical Journal, 316, 1356–1359.

    PubMed  Google Scholar 

  • Crook, J., Weir, R., & Tunks, E. (1989). An epidemiological follow-up survey of persistent pain sufferers in a group family practice and specialty pain clinic.Pain, 36, 49–61.

    Article  PubMed  Google Scholar 

  • Deyo, R., Bass, J., Walsh, N., Schoenfeld, L., & Ramamurthy, S. (1988). Prognostic variability among chronic pain patients: implications for study design, interpretation, and reporting.Archives of Physical Medicine and Rehabilitation, 69, 174–178.

    PubMed  Google Scholar 

  • Deyo, R., & Phillips, W. (1996). Low back pain. A primary care challenge.Spine, 21, 2826–2832.

    Article  PubMed  Google Scholar 

  • Dzewaltowski, D.(1989). Towardamodelofexercise motivation.Journal of Sport&Exercise Psychology, 11, 251–269.

    Google Scholar 

  • Estlander, A.-M., Vanharanta, H., Moneta, G., & Kaivanto, K. (1994). Anthropometric variables, self-efficacy beliefs, and pain and disability ratings on the isokinetic performance of low back pain patients.Spine, 19, 941–947.

    Article  PubMed  Google Scholar 

  • Hubert, L., & Levin, J. (1976). A general statistical framework for assessing categorical clustering in free recall.Psychological Bulletin, 83, 1072–1080.

    Article  Google Scholar 

  • Johansson, E. (1999).Exercise-based physiotherapy management of patients with persistent, non-specific low back pain. A cognitive-behavioural approach to assessment and treatment in a primary care setting. Uppsala, Sweden: Uppsala University.

    Google Scholar 

  • Johansson, E., & Lindberg, P. (1998). Subacute and chronic low back pain. Reliability and validity of a Swedish version ofthe Roland and Morris Disability Questionnaire.Scandinavian Journal of Rehabilitation Medicine, 30, 139–143.

    Article  PubMed  Google Scholar 

  • Kaivanto, K., Estlander, A.-M., Moneta, G., & Vaharanta, H. (1995). Isokinetic performance in low back pain patients: the predictive powerof the self-efficacy scale.Journal of Occupational Rehabilitation, 5, 87–99.

    Article  Google Scholar 

  • Kerns, R., Turk, D., & Rudy, T. (1985). The West Haven—Yale Multidimensional Pain Inventory (WHYMPI).Pain, 23, 345–356.

    Article  PubMed  Google Scholar 

  • Lousberg, R., Van Breukelen, G., Groenman, N., Schmidt, A., Arntz, A., & Winter, F. (1999). Psychometric properties of the multidimensional pain inventory, Dutch language version (MPI-DLV).Behaviour Research and Therapy, 37, 167–182.

    Article  PubMed  Google Scholar 

  • Okifuji, A., Turk, D., & Eveleigh, D. (1999). Improving the rate of classification of patients with the multidimensional pain inventory (MPI): Clarifying the meaning of “significant other.”Clinical Journal of Pain, 15, 290–296.

    Article  PubMed  Google Scholar 

  • Roland, M.,& Morris, R. (1983). A studyofthe natural historyofback pain: Part I.Developmentofa reliable and sensitive measure of disability in low-back pain.Spine, 8, 141–144.

    Article  PubMed  Google Scholar 

  • Rudy, T., Turk, D., Kubinski, J., & Zaki, H. (1995). Differential treatment responses of TMD patients as a function of psychological characteristics.Pain, 61, 103–112.

    Article  PubMed  Google Scholar 

  • Skovron, M.(1992). Epidemiologyoflow backpain.Baillière’s Clinical Rheumatology, 6, 559–573.

    Article  PubMed  Google Scholar 

  • Tabachnic, B.,&Fidell, L.(1996).Using multivariate statistics.(3rd ed.). New York: HarperCollins.

    Google Scholar 

  • Turk, D., Okifuji, A., Sinclair, J., & Starz, T. (1996). Pain, disability, and physical functioning in subgroups of patients with fibromyalgia.Journal of Rheumatology, 23, 1255–1262.

    PubMed  Google Scholar 

  • Turk, D., Okifuji, A., Sinclair, J., & Starz, T. (1998). Differential responses by psychosocial subgroups of fibromyalgia syndrome patients to an interdisciplinary treatment.Arthritis Care and Research, 11, 397–404.

    Article  PubMed  Google Scholar 

  • Turk, D., & Rudy, T. (1987). Toward a comprehensive assessment of chronic pain patients.Behaviour Research and Therapy, 25, 237–249.

    Article  PubMed  Google Scholar 

  • Turk, D.,& Rudy,T. (1988). Towardan empirically derived taxonomy ofchronic pain patients: Integration of psychological assessment data.Journal of Consulting and Clinical Psychology, 56, 233–238.

    Article  PubMed  Google Scholar 

  • Turk, D.,& Rudy, T.(1990a). Neglected factorsinchronic pain treatment outcome studies: Referral patterns, failure to enter treatment and attrition.Pain, 43, 7–25.

    Article  PubMed  Google Scholar 

  • Turk, D., & Rudy, T. (1990b). The robustness of an empirically derived taxonomy of chronic pain patients.Pain, 43, 27–35.

    Article  PubMed  Google Scholar 

  • Turk, D.,& Rudy, T. (1992). Classification logic and strategies in chronic pain.InD. Turk& R. Melzack (Eds.),Handbook of pain assessment (pp. 409–428). New York: Guilford.

    Google Scholar 

  • van den Hoogen, H., Koes, B., van Eijk, J., Bouter, L., & Deville, W. (1997). Pain and health status of primary care patients with low back pain.Journal of Family Practice, 44, 187–192.

    PubMed  Google Scholar 

  • van den Hoogen, H., Koes, B., van Eijk, J., Bouter, L., & Deville, W. (1998). On the course of low back painingeneral practice:aone year followupstudy.Annals of the Rheumatic Diseases, 57, 13–19.

    Article  PubMed  Google Scholar 

  • Von Korff M., & Saunders, K. (1996). The courseofback paininprimary care.Spine, 21, 2833–2839.

    Article  Google Scholar 

  • Waddell, G. (1987). A new clinical model for the treatment of low back pain.Spine, 12, 632–644.

    Article  PubMed  Google Scholar 

  • Yordy, G., & Lent, R. (1993). Predicting aerobic exercise participation: social cognitive, reasoned action, and planned behavioral models.Journal of Sport & Exercise Psychology, 15, 363–374.

    Google Scholar 

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Correspondence to Eva Johansson.

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Johansson, E., Lindberg, P. Low back pain patients in primary care: Subgroups based on the multidimensional pain inventory. Int. J. Behav. Med. 7, 340–352 (2000). https://doi.org/10.1207/S15327558IJBM0704_05

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