Skip to main content
Article
The influence of psychological factors on pre-operative levels of pain intensity, disability and health-related quality of life in lumbar spinal fusion surgery patients
Physiotherapy (2010)
  • Allan D. Abbott
  • Raija Tyni-Lenné
  • Rune Hedland
Abstract

Objectives - To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.

Design - Cross-sectional, correlation study.

Setting - Orthopaedic outpatient setting in a tertiary hospital.

Participants - One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.

Measures - Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.

Results - The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.

Conclusions - This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.

Keywords
  • spinal fusion,
  • disability,
  • quality of life,
  • mental disorders,
  • fear avoidance,
  • mediation
Disciplines
Publication Date
September 1, 2010
Publisher Statement
Citation only.

Abbott, A. D., Tyni-Lenné, R., & Hedlune, R. (2010). The influence of psychological factors on pre-operative levels of pain intensity, disability and health-related quality of life in lumbar spinal fusion surgery patients. Physiotherapy, 96(3), 213-221.

Access the Journal's homepage.

© Copyright Chartered Society of Physiotherapy, 2010. Published by Elsevier Inc. All rights reserved.
Citation Information
Allan D. Abbott, Raija Tyni-Lenné and Rune Hedland. "The influence of psychological factors on pre-operative levels of pain intensity, disability and health-related quality of life in lumbar spinal fusion surgery patients" Physiotherapy Vol. 96 Iss. 3 (2010)
Available at: http://works.bepress.com/allan_abbott/2/