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Are illness perceptions and patient self-care enablement mediators of treatment effect in best practice physiotherapy low back pain care? Secondary mediation analyses in the BetterBack trial

Authors :
Fors, Maria
Öberg, Birgitta
Enthoven, Paul
Schröder, Karin
Hesser, Hugo
Hedevik, Henrik
Abbott, Allan
Fors, Maria
Öberg, Birgitta
Enthoven, Paul
Schröder, Karin
Hesser, Hugo
Hedevik, Henrik
Abbott, Allan
Publication Year :
2023

Abstract

Introduction: A best practice physiotherapy model of care (BetterBack MoC) for low back pain (LBP) aimed to improve patients illness perceptions and self-care enablement, according to the Common-Sense Model of Self-Regulation (CSM). Objective: To confirm if illness perceptions and patient self-care enablement, in line with the CSM, are mediators of treatment effects on disability and pain of the BetterBack MoC for patients with LBP compared to routine primary care. A secondary aim was to explore if illness perceptions and patient self-care enablement are mediators of guideline adherent care. Methods: Pre-planned single mediation analyses tested whether hypothesized mediators at 3 months mediated the treatment effect of the MoC (n = 264) compared to routine care (n = 203) on disability and pain at 6 months. Secondary mediation analyses compared guideline adherent care with non-adherent care. Results: No indirect effects were identified. The BetterBack intervention did not have superior effects over routine care on the hypothesized mediators. Illness perceptions and self-care enablement were significantly associated with disability and pain at 6 months. Secondary analyses showed significant indirect effects of guideline adherent care through tested mediators. Conclusion: Despite no indirect effects, patients illness perceptions and self-care enablement were associated with disability and back pain intensity outcomes and are potentially relevant treatment targets.<br />Funding Agencies|Swedish Research Council [2017?x?01444]; Research Council in Southeast Sweden [FORSSx?660371, FORSS?x?757721, FORSS?x?931966]; Region of Ostergotland [RO-938179, RO-921021]

Details

Database :
OAIster
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1387005798
Document Type :
Electronic Resource
Full Text :
https://doi.org/10.1080.09593985.2023.2210676