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Influence of Educational Attainment on Pain Intensity and Disability in Patients With Lumbar Spinal Stenosis Mediation Effect of Pain Catastrophizing

Cited 20 time in Web of Science Cited 20 time in Scopus
Authors
Kim, Ho-Joong; Kim, Sung-Chan; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S.
Issue Date
2014
Publisher
Lippincott, Williams & Wilkins
Citation
Spine, vol.39 no.10, pp. E637 - E644
Keywords
educational attainmentlumbar spinal stenosiscatastrophizingmediation analysisbootstrapping
Abstract
Objective. To investigate the infl uence of educational attainment
on the level of pain intensity and disability in patients with lumbar
spinal stenosis (LSS) and determine how coping behavior, such as
catastrophizing, may mediate the association between educational
attainment and clinical impairments.
Summary of Background Data. Educational attainment has
been thought to infl uence disability caused by chronic painful
disease, mediated by pain behavior or a coping strategy such as
catastrophizing. Nevertheless, little is known about the role of
educational attainment on pain intensity or disability related with
LSS.
Methods. A total of 155 patients who were diagnosed as
degenerative LSS participated in the study. Data on detailed medical
history, physical examination, and series of questionnaires were
collected, including pain catastrophizing scale, Oswestry Disability
Index, and visual analogue pain scale for back and leg pain. For
measures of socioeconomic status, educational attainment and
occupation were assessed. Radiological analysis was performed
using magnetic resonance images and computed tomographic
scans. After adjustment of covariates, multivariate regression analysis was used to assess each component of the proposed
mediation models among visual analogue pain scale for back/leg
pain, Oswestry Disability Index, the level of education, occupation
and pain catastrophizing scale. Mediation was also assessed by the
bootstrapping technique.
Results. Educational attainment was negatively correlated with
pain intensity, disability, and catastrophizing. Pain catastrophizing
were also signifi cantly correlated with disability and pain intensity
for back/leg pain in the patients with LSS. In the relationship among
variables, the mediation analysis with bootstrapping clearly showed
the role of catastrophizing in the mediation between visual analogue
pain scale for back pain/leg pain, Oswestry Disability Index, and the
level of education.
Conclusion. This study demonstrated that lower educational
attainment was associated with increased pain intensity and
disability in patients with LSS, which was mediated by the coping
mechanism, catastrophizing.
Language
English
URI
https://hdl.handle.net/10371/95794
DOI
https://doi.org/10.1097/BRS.0000000000000267
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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