Page 78 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij

Chapter 4
Ongoing research explored this in more depth and added the dimensions of Timeline cyclical (periodical changes in symptoms), Coherence (making sense of the illness), Emotional Response (impact on emotional level) and Concern (anxiousness about the illness) to the CSM19,5.
In most MSP cases (i.e. low back pain), a specific cause for the pain cannot be identified and consequently MSP is frequently labelled as non-specific14,6. Non-specific MSP can be classified according to the duration of pain as acute (< 7 weeks), subacute (7-13 weeks) or persistent (> 13 weeks)10 (Dionne et al. 2008). It is not known whether IPs differ between acute and chronic patients with MSP.
Therefore, our first research question was:
Do illness perceptions differ between patients with acute, subacute and persistent musculoskeletal pain?
A second important topic is to identify prognostic factors for MSP outcomes and there are a few well-known prognostic factors in relation to the ongoing patient burden of MSP: pain intensity, limitations in physical functioning, multiplicity of pain-sites, pain duration and the psychological factors somatization, distress, anxiety and depression23,14,22,1,20. However, little is known about the additional role IPs might play in pain intensity and limitations in physical functioning, up and above the prognostic value of these well-known prognostic factors. Especially in outpatients with MSP attending physical therapy practices this is unknown. In this multicentre explorative cross-sectional study, we hypothesized that higher scores on IPs, in addition to these well-known factors, would be associated with higher pain intensity and limitations in physical functioning in MSP.
Therefore, our second research question was:
What is the additional association of illness perceptions with pain intensity or limitations in physical functioning in addition to the independent factors pain sites, pain duration, and the psychological factors somatization, distress, anxiety, and depression in patients with musculoskeletal pain, adjusted for gender and age?
Methods
Design and Setting
This multicentre cross-sectional study took place at 29 primary care physiotherapy clinics across The Netherlands. Physiotherapists at these centres collected the data as part of their Master of Physiotherapy study at University of Applied Sciences Utrecht, The Netherlands Participants were asked to complete several questionnaires prior to their first consultation.
76