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Ability of Spine Specialists to Identify Psychosocial Risk Factors as Obstacles to Recovery in Patients with Low Back Pain-Related Disorders

Asian Spine Journal 2021년 15권 2호 p.224 ~ 233
Patel Mohammed Shakil, Lee Kwang Chear, Dhake Rakesh Padmakar, Longworth Stephen, Sell Philip,
소속 상세정보
 ( Patel Mohammed Shakil ) - Nottingham University Hospitals Queen’s Medical Centre Centre for Spinal Studies and Surgery
 ( Lee Kwang Chear ) - University Hospitals of Leicester NHS Trust Leicester General Hospital Division of Clinical Research
 ( Dhake Rakesh Padmakar ) - Nottingham University Hospitals Queen’s Medical Centre Centre for Spinal Studies and Surgery
 ( Longworth Stephen ) - University Hospitals of Leicester NHS Trust Leicester General Hospital Orthopaedic Spine Clinic
 ( Sell Philip ) - Nottingham University Hospitals Queen’s Medical Centre Centre for Spinal Studies and Surgery

Abstract


Study Design: Prospective study.

Purpose: Yellow flags are psychosocial associated with a greater likelihood of progression to persistent pain and disability. These are referred to as obstacles to recovery. Despite their recognized importance, it is unknown how effective clinicians are in detecting them. The primary objective of this study was thus to determine the effectiveness of spine specialist clinicians in detecting the presence of yellow flags in patients presenting to an orthopedic outpatient clinic with low back-related disorders.

Overview of Literature: Psychosocial factors have been previously studied as important predictors of prognosis in patients with low back pain. However, the ability of spinal specialist to identify them remains unknown.


Methods: A prospective, single-center, consecutive cohort study was conducted over a period of 30 months. All new patients with low back-related disorders regardless of pathology completed a Yellow Flag Questionnaire that was adapted from the psychosocial flags framework. Clinicians assessing these patients completed a standardized form to determine which and how many yellow flags they had identified during the consultation.

Results: A total of 130 patients were included in the analysis, and the clinicians reported an average of 5 flags (range, 0?9). Fear of movement or injury was the most frequently reported yellow flag, reported by 87.7% (n=114) of patients. Clinician sensitivity in detecting yellow flags was poor, correctly identifying only 2 flags, on average, of the 5 reported by patients, with an overall sensitivity of only 39%.

Conclusions: The ability of spine specialists to identify yellow flags is poor and can be improved by asking patients to complete a simple screening questionnaire.

키워드

Lower back pain; Psychosocial factors; Questionnaires

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