title: An evidence-based information booklet helps reduce fear-avoidance beliefs after first-time discectomy for disc prolapse.
abstract: OBJECTIVE
  We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy.
  
  
  METHODS
  In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires.
  
  
  RESULTS
  At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008).
  
  
  CONCLUSIONS
  Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS.
  NCT00761111.
authors.affiliation: Service de médecine physique et de réadaptation, centre hospitalier Jacques-Lacarin, 03100 Vichy, France.
authors.forename: D
authors.initials: D
authors.lastname: Claus
authors.affiliation: Université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service de médecine physique et de réadaptation, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France. Electronic address: ecoudeyre@chu-clermontferrand.fr.
authors.forename: E
authors.initials: E
authors.lastname: Coudeyre
authors.affiliation: Service de neurochirurgie, CHU Clermont-Ferrand, université Clermont-Auvergne, 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Chazal
authors.affiliation: Service de neurochirurgie, CHU Clermont-Ferrand, université Clermont-Auvergne, 63003 Clermont-Ferrand Cedex 1, France.
authors.forename: B
authors.initials: B
authors.lastname: Irthum
authors.affiliation: Délégation Recherche Clinique & Innovation, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Mulliez
authors.affiliation: Université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Service de médecine physique et de réadaptation, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: P
authors.initials: P
authors.lastname: Givron
mesh_terms: D000328:Adult; D001362:Avoidance Learning; D004185:Disability Evaluation; D017586:Diskectomy / Q000523:psychology*; D019317:Evidence-Based Medicine; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic
keywords: Booklet; Discectomy; Fear-avoidance beliefs; Low back pain; Self-care