Poor Health Literacy Not Major Factor in LBP Disability

Subjective beliefs, avoidance behaviors due to fear related to higher disability levels
By Lindsey Marcellin
HealthDay Reporter

THURSDAY, July 8 (HealthDay News) -- Beliefs about chronic low back pain (CLBP), as well as behaviors related to fear of pain, have more effect on disability than pain intensity or LBP health literacy, according to research published in the July issue of Pain.

Andrew M. Briggs, Ph.D., of the Curtin University of Technology in Perth, Australia, and colleagues examined the health literacy of individuals with CLBP. Via questionnaires, data regarding severity of pain, LBP-related disability, fear avoidance behaviors, beliefs about CLBP, and pain catastrophizing were obtained from 56 participants with CLBP and 61 participants without a history of CLBP. A standardized health literacy test, the Short-form Test of Functional Health Literacy in Adults (S-TOFHLA), was also administered, and a subgroup of 36 patients with CLBP was interviewed to obtain more detailed information. The participants with CLBP were split into a high disability group (CLBP-high) and a low disability group (CLBP-low).

The researchers found that the most important correlates of disability related to CLBP were LBP-related beliefs and behaviors, rather than pain intensity and health literacy skills. Health literacy scores did not correlate with LBP beliefs and attitudes. Qualitatively, CLBP-high participants described their back pain more in terms of anatomic pathology, and had a more passive coping style compared to CLBP-low participants. Despite adequate scores on the S-TOFHLA, many CLBP participants described difficulties in finding, understanding, and making use of LBP information.

"Quantitative data confirmed that LBP-related beliefs and behaviors, rather than pain intensity and functional health literacy skills are important correlates of LBP-disability. Despite the S-TOFHLA scores indicating that participants had adequate functional health literacy, qualitative data highlighted difficulties in seeking, understanding and utilizing LBP-related information," the authors write.

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