Short summary

Within a consecutive series of patients referred to a public secondary care spine department with non-specific low back pain, this study tests the clinimetric performance of the questionnaire Patient Enablement Instrument.

The Patient Enablement Instrument is a measurement of the ability to understand and cope with illness as well as measuring empowerment.

Rationale

Low back pain (LBP) is commonly experienced within most populations, and non-specific low back pain (nsLBP) is the most frequent diagnosis among patients with LBP.

Due to the non-specificity and often chronic nature, an essential part of the treatment is to support self-management.

A measurement of the ability to self-manage is the Patient Enablement Instrument (PEI), which measures the patients' ability to understand and cope with illness as well as their empowerment when attended in primary care.

Recently the Patient Enablement Instrument for Back Pain (PEI-BP) has been developed based on the PEI and psychometrically tested on a cohort of nsLBP patients in primary care in Denmark. Care targeting recent-onset nsLBP is initiated in the primary sector and only continued in secondary sector care if pain or disabilities are severe or worsening, or if symptoms seem intractable. As such, patients with LBP referred to a secondary sector care setting are presenting with more persisting symptoms, a long history of illness, and risks of affected quality of life, which might affect their coping abilities and empowerment. Consequently, the psychometric properties of the PEI-BP questionnaire may not hold in a secondary sector LBP population and further testing is warranted.

Aim

The overall aim of this study is to assess the psychometric properties of the PEI-BP questionnaire in a secondary sector care cohort of patients with nsLBP.

Description of the cohort

A consecutive series of patients referred to a public secondary care spine department, due to continued or severe spine-related symptoms compromising daily activities despite prior interventions or care.

The patients are referred from primary or secondary care primarily within the Region of Southern Denmark, age 18 or above, presenting only minor or moderate comorbidity (ASA-score <3) and accepted for elective diagnostics, and possibly medical or surgical treatment.

Consequently, patients with spinal pathology such as malignancy, infection, inflammatory arthritis, or notable metabolic bone disease at the time of referral are not accepted at the department.

Data and biological material

Data will be collected from Patient-Reported Outcome measures and the Electronic Patient Journal.

Content validity will be examined using semi-structured interviews.

*PROM questionnaires as standard collected entering the spine department: EQ-5D, Oswestry Disability Index, Visual analog scale, SF-36, and Fear-Avoidance Belief Questionnaire (FABQ) items 1 and 2.

*From the Electronic Patient Journal: ICD-10 diagnostic codes, marital status, CPR.

*Collected via OPEN/RedCap: PEI-BP and Brief Illness Perception Questionnaire.

Collaborating researchers and departments

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark

• Henrik Hein Lauridsen