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Health Care Providers' Attitudes and Beliefs About Functinal Impairments And Chronic Back Pain.

Rainville, James M.D.; Bagnall, David M.D.; Phalen, Linda R.N.
Clinical Journal of Pain:
Editorial: PDF Only

Objective: This study validated a measure entitled the Health Care Providers' Pain and Impairment Relatinship Scale (HC- PAIRS) for assessing the attitudes and beliefs of health care providers about functional expectation for chronic low back pain patients. HC-PAIRS was developed by modifying the Pain and Impairment Relationship Scale (PAIRS) used to assess the attitudes and beliefs of chronic pain patients.

Design: This study surveyed 150 community health care providers and 66 functional retoraton providers using HC- PAIRS. HC-PAIRS consists of 15 items attributing back pain patients ' impairment and disability to pain, followed by a seven-point Likert scale anchored withdegrees of agreement and disagreement. Reliability of HC-PAIRS was determined wsing Cronback's alpha. Factor analysis was performed to explore the dimensions of attitudes and beliefs. Validity was detrmined by HC-PAIRS accurately measuring the pain attitdes and beliefs of fuctional restoration providers, who have a stated philophy concerning this notion.

Results: For the 150 community health care providers, HC-PAIRS revealed a Cronbach's alpha of 0.78. Factor analysis showed foru dimensions of attitudes and beliefs measures by HC- PAIRS, which were entitles " functional expectations," "social expectations," " jeed for cure," and "projected cognition."

Community providers showed a meanscore of 52 (S.D=10). Most respondents were neutral or disagreed somewhat with the notionthat chronic back pain should limit fuctionla performance, but a wide range of responses were noted (range 33-), indicating that diverse pain attitudes and beliefs are held.

The 66 fuctional restoration providers had a mean HC-PAIRS score of 38 (S.D.= 7), and a range of scores form 26- 52 was found. As expected, these score corresponded to disagreement with the notion that chronic low back pain justifies impairments and disability. HC-PAIRS may be useful to health care providers intereted inexamining this notion.

(C) Lippincott-Raven Publishers.