Patient-preference disability assessment for disabling chronic low back pain: a cross-sectional survey.
METHODS
A cross sectional survey. OBJECTIVE.: To assess patient priorities in disability and restriction in participation with disabling chronic low back pain (CLBP) by use of the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) and to compare this questionnaire with other outcome measures widely used in this situation.


BACKGROUND
Disability and participation restriction are widely assessed in CLBP but do not account for patient priorities. Knowing what is important to patients could be useful to help form treatment goals and plans.


METHODS
A total of 150 patients hospitalized in a tertiary care teaching hospital for the management of CLBP were enrolled in the study. Evaluation was by the MACTAR, the Quebec Back Pain Disability Questionnaire (QUEBEC), the Hospital Anxiety and Depression scale, the Fear-Avoidance Beliefs Questionnaire, the Coping Strategies Questionnaire, and pain and handicap visual analog scales. Correlations between the MACTAR score and scores for other scales were analyzed by the Spearman coefficient.


RESULTS
On the MACTAR, patients with CLBP cited as most important 3 disability domains classified by the International Classification of Functioning, Disability, and Health: mobility (n = 23 activities, 165 times, 33% of the patients); community, social, and civic life (n = 7 activities, 138 times, 27.6% of the patients); and domestic life (n = 10 activities, 123 times, 24.6% of the patients). Patients ranked first in importance 37 different activities, especially sport (n = 29 times; 19.3% of the patients), shopping (n = 14; 9.3% of the patients), and walking (n = 13; 8.7% of the patients). The MACTAR score was correlated moderately with visual analog scale handicap (r = 0.51), weakly with the QUEBEC score (r = 0.40), and not at all with Hospital Anxiety and Depression scale, Fear-Avoidance Beliefs Questionnaire, and Coping Strategies Questionnaire scores.


CONCLUSIONS
For assessing priorities in disability and participation restriction among patients with CLBP, the MACTAR has acceptable construct validity. The weak correlation between QUEBEC and MACTAR scores suggests that the latter scale adds useful information for assessing the health priorities of disabled CLBP patients.
AP-HP Service de Médecine Physique et Réadaptation, Hôpital Cochin, Institut Federatif de Recherche sur le Handicap (IFR 25), Université Paris Descartes, INSERM, Paris, France.
Katherine
K
Sanchez
Agathe
A
Papelard
Christelle
C
Nguyen
Marylène
M
Jousse
François
F
Rannou
Michel
M
Revel
Serge
S
Poiraudeau
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D002908:Chronic Disease / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology; D005260:Female; D006292:Health Priorities / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D017116:Low Back Pain / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult