[Predictors of quality of life after orthopedic treatment of lower back pain due to lumbar intervertebral disc disorders].
OBJECTIVE
To investigate the relevance of somatic, psychic and psychosocial factors on the health-related quality of life at the one year follow-up of patients with lower back pain.


METHODS
Prospective cohort study of 109 patients recruited consecutively. At baseline and at one year follow-up self-report instruments were administered to evaluate health-related quality of life (SF-36), psychic or psychological distress (SF-36), and coping strategies (FKV-LIS).


RESULTS
In regards to the physical and mental dimensions of the quality of life at follow-up, psychosocial factors evaluated at baseline were far more relevant. Using a multiple regression analysis we were able to account for 38 % of the variance in the physical dimension of the quality of life and 45 % of the variance in the mental dimension. In these two dimensions the factors "psychic distress" (GSI, SCL-90-R) and "sick leave" were significant predictors, in the mental dimension additionally "doctor shopping". Beyond that, impaired health-related quality of life at baseline as well as at follow-up was related to depressive coping (FKV-LIS).


CONCLUSIONS
The study shows the high impact of psychic and psychosocial factors on health-related quality of life in patients with chronic lower back pain.
Nickel
Ralf
R
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der Johnnes Gütenberg-Universität Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany. ranickel@mail.uni-mainz.de
Egle
Ulrich T
UT
D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000523:psychology* / Q000534:rehabilitation; D017116:Low Back Pain / Q000523:psychology* / Q000534:rehabilitation; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012803:Sick Role; D018434:Sickness Impact Profile; D013167:Spondylitis, Ankylosing / Q000523:psychology* / Q000534:rehabilitation