Predicting health-related quality of life in patients with low back pain

Study Design. Cross-sectional surveys of health-related quality of life (HRQOL) in patients with low back pain at ambulatory clinics plus 8 weeks of follow-up. Objective. The objective of this study is to predict the HRQOL in patients with low back pain. Summary of Background Data. There is disagreement on the relative contribution of pain, physical impairment, functional status, and psychological factors on the disability and HRQOL in patients with low back pain. Methods. Data were collected from 232 patients with low back pain who were consecutively recruited from several clinics of physical medicine and rehabilitation. Every patient received physical examination and completed a set of questionnaire, including the Taiwan version of the Brief Questionnaire of the World Health Organization on quality of life (WHOQOL-BREF), Modified Roland and Morris Disability Questionnaire, and visual analogue scale for pain intensity and for HRQOL. These patients were observed with a mail questionnaire 8 weeks later. The results of WHOQOL-BREF were also compared to those obtained from another 213 healthy volunteers who were accompanied persons with patients, volunteer workers in hospitals, and hospital employees. Results. Results showed that there were significant correlations of HRQOL with pain intensity, disability scale, and disability days. Among the results of physical examination, lumbosacral radiculopathy was the only factor with moderate correlation with HRQOL. The significant predictors for HRQOL included physical domain, psychological domain, pain intensity, and family income. Among all the 232 study patients, 100 of them responded to the follow-up questionnaire. Changes in environmental domain, disability days, educational level, receiving herb drugs, and physiotherapy were the significant predictors for the changes of HRQOL. Conclusions. The HRQOL of patients with low back pain depended on functional status and psychological factors more than simple physical impairment. Future intervention may need to put more emphasis on improving functional status and psychological stress for these patients.