Browsing by Subject "pain self-efficacy"

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Evaluating the Association of Gender as it Pertains to Health-Related Quality of Life Outcomes in Chronic Low Back Pain Patients
(2024-05) Slater, Madeline L.; Cunningham, Mark W., Jr.
BACKGROUND: Six hundred and nineteen million individuals worldwide are affected by low back pain, with this number estimated to increase to 850 million by the year 20501. Low back pain is also the leading cause of disability worldwide2 and contributes to the limitation of activities and needing leave from work resulting in severe medical burdens and economic costs3,4. Males and females (referred to as gender throughout this project based on variables in the NIH Minimum Dataset form for Chronic Low Back Pain) have recorded differences in chronic low back pain outcomes including, but not limited to, treatment outcomes and psychosocial outcomes. Individuals with female sex traditionally take on the female gender with associated norms and roles, and those with male sex often take on male gender and associated roles. Previous literature on this topic varies by location and typically reports on local patients. The PRECISION Pain Research Registry differs from other research projects because the participants involved in this study are from locations within the continental United States. This diversity in terms of location, ethnicity, and race of study participants allows a larger and more applicable representation of the U.S. population in terms of chronic low back pain management. Discrepancies on whether gender has an effect on health-related quality of life outcomes in chronic low back pain patients in the literature is controversial. Thus the link between gender and chronic low back pain outcome is unknown and is the focus of this study, in which we will use the PRECISION Pain Research Registry to examine the relationship. HYPOTHESIS: We hypothesize that males and females with chronic low back pain have different health-related quality of life outcomes and these differences are correlated to pain catastrophizing and pain-self efficacy scores. The specific aims of the project include (1) analyzing the association between gender and pain catastrophizing in chronic low back pain patients, (2) analyzing the association between gender and pain self-efficacy scores in chronic low back pain patients, and (3) using repeated measures to assess differences between males and females in chronic low back pain outcomes pertaining to health-related quality of life over a 12-month period. METHODS: Data from 1,478 patients in the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION) were analyzed using factors such as gender, age, race, ethnicity, smoking habits, low back pain duration, opioid use for low back pain treatment, occurrence of low back pain surgery, education level, comorbidities, non-pharmacological treatments, and body mass index (BMI). Importantly, this project conducted analysis to determine the association between gender and pain catastrophizing, pain self-efficacy, and health-related chronic low back pain outcomes. The health-related quality of life outcomes of sleep disturbance, pain interference, anxiety, depression, and energy levels are taken from the negative outcomes from the Patient-Reported Outcomes Measurement Information System (PROMIS) scale. RESULTS: Overall, there were no statistically significant associations between gender and pain catastrophizing scores with males having slightly higher scores compared to females. No association was seen between gender and pain self-efficacy. Male patients once again had slightly higher scores but the mean score difference was not significant. Results from interaction term analysis showed that pain catastrophizing and pain self-efficacy scores on their own have an effect on SPADE health-related quality of life outcomes but upon the introduction of gender, the effect becomes negligible.