title: Attributions, stress, and work-related low back pain.
abstract: Occupational low back pain (LBP) is a major cause of morbidity and cost. Efforts to control LBP are largely unsuccessful, and better understanding of risks is needed, especially psychological factors. The purpose of this research was to assess the association between worker attributions and LBP. Attributing LBP to internal causes may increase the worker's perceived control, whereas external attribution may cause distress. A new model was developed to explore these associations. A cross-sectional design was used in this study of 278 garment workers. Data were gathered by a self-administered questionnaire and through direct observation. Responses to questions on worker attributions of LBP cause and knowledge of back safety were subjected to factor analysis and other psychometric evaluation to develop scales. Six hypotheses were tested using multivariate logistic regression. Workers who scored high in internal attribution were more likely to be knowledgeable of back safety (OR = 3.7, 95% CI = 2.0-6.7). Workers reporting high demand were more likely to report LBP (OR = 2.3, 95% CI = 1.2-4.4). Workers attributing LBP to job tasks were more likely to report LBP (OR = 3.2, 95% CI = 1.5-6.9), and those reporting high supervisor support were less likely to report LBP (OR = 0.23, 95% CI = 0.08-0.66). Workers with annual incomes above 15,000 dollars were more likely to report LBP in the test of both the Demand-Control-Support and Attribution models (OR = 2.8, 95% CI = 1.2-6.9 and OR = 4.1, 95% CI = 1.5-11.1, respectively). While both models appeared to be useful for the study of low back pain, the R(2)(L) of the Demand-Control-Support model equaled only 11.9 percent, whereas the Attribution model equaled 26.2 percent. This study provides evidence that attribution theory is useful in the study of LBP, including in future interventions in the prevention of LBP.
authors.affiliation: Department of Health Sciences, Illinois State University, Normal, Illinois, USA.
authors.forename: George
authors.initials: G
authors.lastname: Byrns
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Agnew
authors.forename: Barbara
authors.initials: B
authors.lastname: Curbow
mesh_terms: D000328:Adult; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016272:Occupational Health; D016017:Odds Ratio; D010358:Patient Participation; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D012924:Social Conditions; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013783:Textile Industry; D014481:United States / Q000453:epidemiology; D016526:Workload