title: Appraisal and coping processes among chronic low back pain patients.
abstract: OBJECTIVE
  Appraisals and coping play important roles in musculoskeletal disorders, but how these aspects develop over time remains unknown. The aim of the current study was to examine the development of pain-related appraisals, coping and well behaviours among chronic low back pain (CLBP) patients.
  
  
  METHODS
  Twenty-two outpatients (15 women, 7 men) of working age were interviewed about past and present experiences of CLBP. The interviews were analysed using Grounded theory.
  
  
  RESULTS
  The majority of the participants used disregarding processes in response to CLBP. The disregarding process developed from a psychological defence into a conscious coping strategy, the transition mediated by a crisis. This defence seemed to protect the participants' self-concept and reduce emotional discomfort, although it did not promote rehabilitation. The disregarding strategy was usually employed in later phases of the disorder and was consistent with active attempts at changing pain-related behaviours. Study limitation: Most of the participants had experienced CLBP for several years, thus the risk of memory bias cannot be ruled out. Furthermore, the sample was composed of relatively healthy subjects, thus the findings may not apply to chronic low back patients in general.
  
  
  CONCLUSIONS
  Acceptance of CLBP favoured rehabilitation and helped participants change pain-related behaviours.
authors.affiliation: Department of Psychology, University of Stockholm, Sweden. hbh@psychology.su.se
authors.forename: Hillevi
authors.initials: H
authors.lastname: Busch
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002908:Chronic Disease; D003674:Defense Mechanisms; D005260:Female; D015438:Health Behavior; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012647:Self-Assessment; D013548:Sweden