LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Mansell, Gemma; Hill, Jonathan C.; Main, Chris; Vowles, Kevin E.; van der Windt, Dani?lle (2016)
Publisher: Churchill Livingstone
Journal: The Journal of Pain
Languages: English
Types: Article
Subjects: Anesthesiology and Pain Medicine, Mediation analysis, psychological intervention, low back pain, Clinical Neurology, Original Report, Neurology, RA
Interventions developed to improve disability outcomes for low back pain (LBP) often show only small effects. Mediation analysis was used to investigate what led to the effectiveness of the Stratified Targeted Treatment (STarT)?Back trial, a large primary care-based trial that treated patients consulting with LBP according to their risk of a poor outcome. The high-risk subgroup, randomized to receive either psychologically-informed physiotherapy (n?=?93) or current best care (n?=?45), was investigated to explore pain-related distress and pain intensity as potential mediators of the relationship between treatment allocation and change in disability. Structural equation modeling was used to generate latent variables of pain-related distress and pain intensity from measures used to identify patients at high risk (fear-avoidance beliefs, depression, anxiety, and catastrophizing thoughts). Outcome was measured using the Roland?Morris Disability Questionnaire. Change in pain-related distress and pain intensity were found to have a significant mediating effect of .25 (standardized estimate, bootstrapped 95% confidence interval, .09?.39) on the relationship between treatment group allocation and change in disability outcome. This study adds to the evidence base of treatment mediation studies in pain research and the role of distress in influencing disability outcome in those with complex LBP. Perspective Mediation analysis using structural equation modeling found that change in pain-related distress and pain intensity mediated treatment effect in the STarT Back trial. This type of analysis can be used to gain further insight into how interventions work, and lead to the design of more effective interventions in future.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • [1] Anderson JC, Gerbing DW. Structural equation modeling in practice: A review and recommended two-step approach. Psychol Bull; 103:411-23, 1988.
    • [2] Baron RM, Kenny DA. The moderator-mediator variable distinction in social T psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc IP Psychol; 51:1173-82, 1986. R C
    • [3] Bentler PM. On tests and indices for evaluating structural models. Pers Individ Dif; 42:825-29, 2007. S U N
    • [4] Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res; 52:69-77, A2002. M
    • [5] Byrne BM. Structural equation modelling with AMOS: Basic concepts, applications, and D programming. (2nd Ed.). London: Routledge, 2010. E T P
    • [6] Chen HT. Theory-driven evaluations. London: Sage, 1990. E
    • [7] Chen HT. Practical program evaluation: Theory-driven evaluation and the integrated evaluation C perspective (2nd Ed.). London: Sage, 2015. C A
    • [8] Damsgård E, Fors T, Anke A, Røe C. The Tampa Scale of Kinesiophobia: A rasch analysis of its properties in subjects with low back and more widespread pain. J Rehabil Med; 39:672-78, 2007.
    • [9] Eccleston C, Williams ACdeC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults (review). Cochrane Database Syst Rev; 2:No. CD007407, 2009. [40] Roland M, Morris R. A study of the natural history of back pain. Part I: Development of a reliable [47] Streiner DL, Norman GR. Health measurement scales: A practical guide to their development and use. (4th Ed). Oxford: Oxford University Press, 2008. 0.05 0.30
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article