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Low Back Pain: A Review of Social Security Data; GP, Public and Patient Beliefs in Jersey

By Julia Morris

Abstract

The published articles from Appendix 6 are not available in the electronic version of this thesis due to copyright restrictions. The full version can be consulted at the University of Leicester Library.This research aimed to investigate the attitudes and beliefs of Jersey’s general population, GPs and patients towards LBP and its management. Trends of sickness certification for LBP for the entire registered working population of Jersey were also investigated. From 1994 to 2003 Incapacity Benefit costs rose sharply (153.4% Long-term Incapacity Benefits (LTI); 76.99% Short-term Incapacity Benefits (STI) and are discussed in relation to changes seen in certification for LBP and other symptom dominated conditions. \ud Investigation of the working population’s attitudes and beliefs revealed that educational attainment was the best single predictor of beliefs about LBP held by those currently suffering with the condition; with those reporting the lowest educational attainment also reporting the most negative beliefs. \ud The internal consistency and test-retest reliability of the Pain Attitudes and Beliefs Scale (PABS) when used with GPs was examined. The measure was found to have adequate internal consistency, test-retest reliability and sensitivity to change. It was subsequently used alongside sickness certification data to determine if GP attitudes and beliefs about LBP influenced their decisions with regard to sick listing LBP patients. Neither PABS factor was able to add to the prediction of numbers of certificates issued; however general propensity to issue sickness certificates did. \ud When combining patient and GP factors a clear interaction was found in relation to prediction of sick-listing for LBP. For the patient, previous absenting with LBP was a risk for future sickness certification; as was high fear avoidance of work. The biopsychosocial orientation of GPs also added to our prediction model and appeared to reduce the likelihood of sick-listing. These findings have implications for current clinical management of LBP. \ud Finally, changes in trends of sickness certification are discussed in relation to both the research work conducted as well as specific service provision changes implemented

Publisher: University of Leicester
Year: 2010
OAI identifier: oai:lra.le.ac.uk:2381/8967

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Citations

  1. (2009a) Jersey Economic Trends 2009. Jersey Economic Trends. St Helier, States of Jersey Statistics Unit.
  2. (1999). [Work ability and gender--physicians' assessment of sick-listed patients]. Tidsskrift for Den Norske Laegeforening,
  3. (1995). 25th General Assembly Report XII. Quality, Effectiveness and Efficiency of Rehabilitation Measures.
  4. (1993). A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear avoidance beliefs in chronic low back pain and disability.
  5. (1998). A population-based study of spinal pain among 35-45-year-old individuals. Prevalence, sick leave, and health care use.
  6. (2006). A population-based survey of back pain beliefs in Canada.
  7. (2000). A review of psychological risk factors in back and neck pain.
  8. (1983). A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain.
  9. (1995). Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place.
  10. (2007). Active exercise, education, and cognitive behavioral therapy for persistent disabling low back pain: a randomized controlled trial.
  11. (2007). Adherence of Irish general practitioners to European guidelines for acute low back pain: a prospective pilot study.
  12. (2004). Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control.
  13. (1993). Altering beliefs about pain and impairment in a functionally oriented treatment program for chronic low back pain.
  14. (2000). An introduction to medical statistics,
  15. (2009). Annual Survey Report 2009. Absence Management.
  16. (1996). Applied multivariate statistics for the social sciences (3rd edn).
  17. (2000). Are fearavoidance beliefs related to the inception of an episode of back pain? A prospective study.
  18. (2006). Are we "fear-avoidant"?
  19. (2002). Assessing intrarater, interrater and test-retest reliability of continuous measurements.
  20. (2004). Back pain and health policy research: the what, why, how, who, and when.
  21. (2000). Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years.[see comment].
  22. (2006). Back pain prevalence and visit rates: estimates from U.S. national surveys,
  23. (2002). Back pain, incapacity for work and social security benefits: an international literature review and analysis, London, The Royal Society of Medicine
  24. (1994). Back Pain.
  25. (2010). Beliefs about Back Pain: results of a population survey of working age adults.
  26. (2005). Beliefs about low back pain in the Norwegian general population: Are they related to pain experiences and health professionals?
  27. (2000). Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention and two forms of information for patients with spinal pain.
  28. (2006). Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care.
  29. (1999). Chronic low back pain in general practice: the challenge of the consultation.
  30. (1988). Chronic pain and functional impairment: assessing beliefs about their relationship.
  31. (2008). Chronic pain--is it a public health problem?[comment].
  32. (1996). Clinical guidelines for the Management of Acute Low Back Pain.
  33. (2001). Clinical guidelines for the management of low back pain in primary care: an international comparison.[see comment].
  34. (1998). Clinical guidelines in the management of low back pain.
  35. (1994). Clinical Practice Guideline Number 14: Acute Low Back Problems in Adults. Rockville, MD, Agency for Health Care Policy and Research.
  36. (1998). Community survey of factors associated with consultation for low back pain.[Erratum appears in BMJ
  37. (1986). Comparative validity of the sickness impact profile and shorter scales for functional assessment in low-back pain.
  38. (2004). Compliance among general practitioners in France with recommendations not to prescribe bed rest for acute low back pain.
  39. (2005). Concepts of rehabilitation for the management of low back pain.
  40. (1995). Continuity and Change: A Review of the Social Security and Health Insurance Schemes in Jersey.
  41. (2003). Current challenges in clinimetrics.
  42. (2002). Current issues in fitness for work certification.
  43. (2001). Determinants of duration of disability and return-to-work after workrelated injury and illness: challenges for future research.
  44. (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society.[Erratum appears in Ann Intern Med.
  45. (2000). Discovering statistics using SPSS for windows,
  46. (1996). Do attitudes and beliefs influence work loss due to low back trouble?
  47. (2000). Do epidemiological results replicate? The prevalence and health-economic consequences of neck and back pain in the general population.
  48. (2005). Do health care providers' attitudes towards back pain predict their treatment recommendations? Differential predictive validity of implicit and explicit attitude measures.
  49. (2009). Early management of persistent non-specific low back pain: summary of NICE guidance.
  50. (2005). Effects of a media campaign on back beliefs is sustained 3 years after its cessation.
  51. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II.
  52. (1998). Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States.[see comment].
  53. (1995). Estimating the prevalence of low back pain in the general population.
  54. Evidence from the South Manchester Back Pain Survey.
  55. (2000). Exploration of physicians' recommendations for activities in chronic low back pain.
  56. (2007). Exploring general practitioner identification and management of psychosocial Yellow Flags in acute low back pain.
  57. (2008). Factors associated with long-term sick leave in sick-listed employees: a systematic review.
  58. (1995). Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.
  59. (2006). Fear of movement/(re)injury predicting chronic disabling low back pain: a prospective inception cohort study.
  60. (2003). Fear of movement/(re)injury, disability and participation in acute low back pain.
  61. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
  62. (2007). Fear-avoidance beliefs about back pain in patients with acute LBP.
  63. (2006). Fear-avoidance beliefs about back pain in patients with subacute low back pain.[see comment].
  64. (2009). Fit for Work? Musculoskeletal Disorders in the European Workforce. London, The Work Foundation.
  65. (2001). Formal education and back pain: a review.
  66. (2008). General practitioner sickness absence certification for low back pain is not directly associated with beliefs about back pain.
  67. (2006). General practitioners' fear-avoidance beliefs influence their management of patients with low back pain.
  68. (2009). General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.
  69. (1999). Generalizing from a controlled trial: the effects of patient preference versus randomization on the outcome of inpatient versus outpatient chronic pain management.
  70. (1995). Good prognosis for low back pain left untampered: A randomized clinical trial
  71. (2009). GP attitudes and self-reported behaviour in primary care consultations for low back pain.
  72. (1997). Guide to Assessing psychosocial yellow flags in acute low back pain.
  73. (2007). Health care practitioners' attitudes and beliefs about low back pain: A systematic search and critical review of available measurement tools.
  74. (2003). Health care provider's attitudes and beliefs towards chronic low back pain: the development of a questionnaire.
  75. (1995). Health care providers' attitudes and beliefs about functional impairments and chronic back pain.
  76. (2004). Health care providers' attitudes and beliefs towards common low back pain: Factor structure and psychometric properties of the HC-PAIRS.
  77. (2005). Health care providers' orientations towards common low back pain predict perceived harmfulness of physical activities and recommendations regarding return to normal activity.
  78. (1995). Health measurement scales: a practical guide to their development and use.,
  79. (2004). High fear-avoiders of physical activity benefit from an exercise program for patients with back pain.
  80. (2005). How does persistent pain develop? An analysis of the relationship between psychological variables, pain and function across stages of chronicity.
  81. (2008). How does the selfreported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists.
  82. (2005). How to assess the reliability of measurements in rehabilitation.
  83. (2002). Identifying psychosocial variables in patients with acute work-related low back pain: the importance of fear-avoidance beliefs.
  84. (2000). Illness schemata in patients with low back pain: Predictions of rehabilitation success.
  85. (2001). Implementation barriers for general practice guidelines on low back pain a qualitative study.
  86. (2004). Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.
  87. (1995). Implicit social cognition: attitudes, self-esteem, and stereotypes.
  88. (2007). Improvements in general practitioner beliefs and stated management of back pain persist 4.5 years after the cessation of a public health media campaign.
  89. (2005). Incidence and course of low back pain episodes in the general population.
  90. (1996). Influence of previous pain experience on the episode incidence of low back pain: results from the South Manchester Back Pain Study.
  91. (1999). Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care.
  92. (2006). Initial patient and clinician expectations of return to work after acute onset of workrelated low back pain.
  93. (1990). Inter-doctor variation in sickness certification.
  94. (2010). Investigating decisions to absent from work with Low Back Pain: A study combining Patient and GP factors.
  95. (1994). Is back pain increasing? Results from national surveys in Finland during 1978/9-1992.
  96. (2006). Is Work Good for Your Health and Wellbeing?, London, The Stationary Office.
  97. (2007). Jersey Annual Social Survey
  98. (2009). Jersey Annual Social Survey 2009. Jersey Annual Social Survey. St Helier, States of Jersey Statistics Unit.
  99. (2008). Jersey in Figures 2008. Jersey in Figures. States of Jersey Statistics Unit.
  100. (2008). Jersey's Resident Population
  101. (1990). Kinesiophobia: a new view of chronic pain behaviour.
  102. (2004). Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships.
  103. (2000). Measures of reliability in sports medicine and science.
  104. (1987). Measuring change over time: Assessing the usefulness of evaluative instruments.
  105. (1998). Medically certified work loss, recurrence and costs of wage compensation for back pain: a follow-up study of the working population of Jersey.
  106. (1996). Musculoskeletal pain: concepts of disease, illness, and sickness certification in health professionals in Norway.
  107. (2004). Needless unemployment: the public health crisis. IN HOLLAND-ELLIOT,
  108. (1997). New Zealand Acute Low Back Pain Guide.
  109. (2001). Occupational health guidelines for the management of low back pain at work: Evidence review,
  110. (2006). Outcome of subacute low back pain: influence of patients' and rheumatologists' characteristics.
  111. (2006). Pain and pain-related fear are associated with functional and social disability in an occupational setting: evidence of mediation by pain-related fear.
  112. (1994). Pain assessment: global use of the Brief Pain Inventory.
  113. (2005). Pain-related fear at the start of a new low back pain episode.
  114. (1999). Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.
  115. (1996). Patient educational material in the management of low back pain in primary care.
  116. (2004). Patient factors associated with duration of certified sickness absence and transition to long-term incapacity.
  117. (2007). Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial.[see comment][summary for patients in Ann Intern Med.
  118. (2001). Population based intervention to change back pain beliefs and disability: three part evaluation.
  119. (2004). Population based intervention to change back pain beliefs: three year follow up population survey.
  120. (2008). Pre-Budget Report
  121. (1996). Predicting poor outcomes for back pain seen in primary care using patients' own criteria.
  122. (2006). Prediction of sickness absence in patients with chronic low back pain: a systematic review.
  123. (1989). Prevalence of back pain among fulltime United States workers.
  124. (1998). Preventing disability from work-related low-back pain. New evidence gives new hope--if we can just get all the players onside.
  125. (2005). Prognosis and the identification of workers risking disability: research issues and directions for future research.
  126. (2005). Prognostic factors for duration of sick leave due to low-back pain in dutch health care professionals.
  127. (2005). Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: a systematic review of the literature.
  128. (2006). Prognostic factors for duration of sickness absence due to musculoskeletal disorders.
  129. (1999). Psychological aspects of pain.[see comment].
  130. (2006). Psychological processes underlying the development of a chronic pain problem: a prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability.
  131. (1978). Psychometric Theory,
  132. (2008). Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain.
  133. (2000). Public perceptions about low back pain and its management: A gap between expectations and reality?, Health Expectations.
  134. (1999). Reliability of isokinetic ankle dorsiflexor strength measurements in healthy young men and women.
  135. (1986). Reliability of measurements. The design and analysis of clinical experiments.
  136. (2002). Report on the 2001 Census.
  137. (2003). Research on unemployment and suicide.
  138. (2004). Returning the chronically unemployed with low back pain to employment.
  139. (2007). Review of Changes to the Incapacity Benefit System.
  140. (2007). Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: a population-based survey.[see comment].
  141. (2003). Routine primary care management of acute low back pain: adherence to clinical guidelines.[see comment].
  142. (2005). Screening to identify patients at risk: profiles of psychological risk factors for early intervention.
  143. (2005). Secondary prevention in health-care and occupational settings in musculoskeletal conditions.
  144. (2008). Self-management education en masse: effectiveness of the Back Pain: Don't Take It Lying Down mass media campaign.
  145. (2010). Self-reported work-related illness and workplace injuries in 2008/09: Resuls from the Labour Force Survey.
  146. (2005). Should treatment of (sub)acute low back pain be aimed at psychosocial prognostic factors? Cluster randomised clinical trial in general practice.[see comment].
  147. (2000). Sick-listing habits among general practitioners in a Swedish county. scandinavian
  148. (1989). Sickness certification in general practice: a review. Family Practice,
  149. (2004). Sickness certification system in the United Kingdom: qualitative study of views of general practitioners in Scotland.
  150. (2009). SJSU (2009b) Jersey Annual Social Survey
  151. (2009). SJSU (2009c) Jersey Economic Trends
  152. (2009). SJSU (2009d) Jersey Labour Market at
  153. (2001). Smallest real difference, a link between reproducibility and responsiveness.
  154. (2005). Social Protection in Jersey: a Comparative Study. St Helier, States of Jersey Employment and Social Security Department.
  155. (2005). SPSS Survival Manual,
  156. (2010). Statistical Bulletin: Labour Market Statistics
  157. (1986). Statistical methods for assessing agreement between two methods of clinical measurement.
  158. (1988). Statistical power analysis for the behavior sciences,
  159. (2001). Stepped care for back pain: activating approaches for primary care.
  160. (1997). Systematic reviews of bed rest and advice to stay active for acute low back pain.
  161. (2009). Tackling Musculoskeletal problems: a guide for clinic and workplace - identifying obstacles using the psychosocial flags framework.,
  162. (2007). Test-retest reliability of knee kinesthesia in healthy adults.
  163. (2010). Test-Retest Reliability of the Pain Attitudes and Beliefs Scale and Sensitivity to Change in a General Practitioner Population.
  164. (2006). The attitudes to back pain scale in musculoskeletal practitioners (ABS-mp): the development and testing of a new questionnaire.
  165. (2002). The back pain beliefs of health care providers: Are we fear-avoidant?
  166. (2004). The Back Pain Revolution,
  167. (2007). The contribution of psychosocial factors to the development of chronic pain: the key to better outcomes for patients?[see comment].
  168. (2000). The economic burden of back pain in the UK.
  169. (1983). The hospital anxiety and depression scale.
  170. (1999). The photographs series of daily activities (PHODA). Heerleen:, School of physiotherapy, Hogeschool Zuyd.
  171. (1999). The Prevalence of Back Pain in Great Britain in 1998. Based on the Office of National Statistics Omnibus Survey Module.
  172. (1999). The prevalence of low back pain in the elderly. A systematic review of the literature.
  173. (1995). The prevalence of low back pain in the literature. A structured review of 26 Nordic studies from
  174. (2000). The prevalence of low back pain: a systematic review of the literature from 1966 to
  175. (2005). The relationship of anticipated pain and fear avoidance beliefs to outcome in patients with chronic low back pain who are not receiving workers' compensation.
  176. (2000). The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire.
  177. (2000). The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain.
  178. (1998). The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults.
  179. (2005). The Scientific and Conceptual Basis of Incapacity Benefits,
  180. (1998). Trends in disability duration and cost of workers' compensation low back pain claims
  181. (2010). Trends in short term incapacity payments for low back pain: a 10 year review of social security data in
  182. (1998). Trends of back pain in eastern Finland, 1972-1992, in relation to socioeconomic status and behavioral risk factors.
  183. (2008). Unemployment and retirement and illhealth: a cross-sectional analysis across European countries.
  184. (2001). Using multivariate statistics,
  185. (2004). Validation of the Brief Pain Inventory for chronic nonmalignant pain.
  186. (2004). Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain.
  187. (2001). Volvo Award winner in clinical studies: Effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice.
  188. (2000). Welfare to work: the role of general practice.
  189. (2006). Why do doctors issue sick notes? An experimental questionnaire study in primary care.
  190. (2005). Why is a treatment aimed at psychosocial factors not effective in patients with (sub)acute low back pain?
  191. (2007). Work and common health problems.[see comment].
  192. (2007). Working backs Scotland: A public and professional health education campaign for back pain,
  193. (2008). Working for a healthier tomorrow: Dame Carol Black's Review of the health of Britain's working age population,
  194. (1990). Written case simulations: Do they predict physician's behaviour?

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