Working with low back pain: problem-solving orientation and function.
A number of ergonomic, workplace and individual psychosocial factors and health behaviors have been associated with the onset, exacerbation and/or maintenance of low back pain (LBP). The functional impact of these factors may be influenced by how a worker approaches problems in general. The present study was conducted to determine whether problem-solving orientation was associated with physical and mental health outcomes in fully employed workers (soldiers) reporting a history of LBP in the past year. The sample consisted of 475 soldiers (446 male, 29 female; mean age 24.5 years) who worked in jobs identified as high risk for LBP-related disability and reported LBP symptoms in the past 12 months. The Social Problem-Solving Inventory and the Standard Form-12 (SF-12) were completed by all subjects. Hierarchical multiple regression analyses were used to predict the SF-12 physical health summary scale from interactions of LBP symptoms with each of five problem-solving subscales. Low scores on positive problem-solving orientation (F(1,457)=4.49), and high scores on impulsivity/carelessness (F(1,457)=9.11) were associated with a steeper gradient in functional loss related to LBP. Among those with a longer history of low-grade LBP, an avoidant approach to problem-solving was also associated with a steeper gradient of functional loss (three-way interaction; F(1,458)=4.58). These results suggest that the prolonged impact of LBP on daily function may be reduced by assisting affected workers to conceptualize LBP as a problem that can be overcome and using strategies that promote taking an active role in reducing risks for LBP. Secondary prevention efforts may be improved by addressing these factors.
Shaw
William S
WS
Liberty Mutual Center for Disability Research, 71 Frankland Road, Hopkinton, MA 01748, USA Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA Department of Veteran's Affairs, Research & Development Office, 810 Vermont Avenue NW, Washington, DC 20420, USA U.S. Army Center for Health Promotion and Preventive Medicine, 5158 Black Hawk Road, Aberdeen Proving Ground, MD 21010, USA University of Maryland, College Park, MD 20742, USA.
Feuerstein
Michael
M
Haufler
Amy J
AJ
Berkowitz
Steven M
SM
Lopez
Mary S
MS
D000328:Adult; D003430:Cross-Sectional Studies; D006804:Ergonomics; D005260:Female; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control*; D008297:Male; D008889:Military Personnel; D009784:Occupational Diseases / Q000517:prevention & control*; D011340:Problem Solving; D012944:Social Support