A predictive model for disability in patients with lumbar disc herniation.
BACKGROUND
Lumbar disc herniation may influence patients' daily activities and social interactions; however, no predictive models of disability could be found for patients with lumbar disc herniation. We aimed to explore predictive factors for disability in patients with lumbar disc herniation.


METHODS
The sample included 216 patients recruited from the orthopedic outpatient clinics at a medical center in northern Taiwan. Data were collected on patients' pain, fatigue, depression, disability, and demographics. Hierarchical multiple regression analysis was used in model verification. Path analysis was used to investigate causal relationships between disability and other factors.


RESULTS
In path analysis, the most influential factor affecting the disability level was the pain level (standardized regression coefficient, b = 0.746), followed by the fatigue level (b = 0.138) and depression level (b = 0.100). The depression level was directly affected by the fatigue level (b = 0.416) and the pain level (b = 0.367), the fatigue level was directly affected by the pain level (b = 0.538), and the pain level was directly affected by age (b = 0.140) and previous surgery (b = 0.260).


CONCLUSIONS
We recommend that health-care providers regularly assess and treat pain and depression to reduce/prevent disability among patients with lumbar disc herniation, even among those who are apparently functioning well in the community.
Department of Nursing, Chang Gung Memorial Hospital, 230, Fu-Hsing 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan. conico70@adm.cgmh.org.tw
Hsin-Ni
HN
Chen
Yun-Fang
YF
Tsai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015984:Causality; D003863:Depression / Q000503:physiopathology; D004185:Disability Evaluation; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000503:physiopathology*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results; D013624:Taiwan