Maladaptive Back Beliefs and Low Back Pain in Nurses: A Longitudinal Study

This population-based longitudinal questionnaire study examined whether back beliefs predicted increased low back pain (LBP) one year after baseline, comparing the phenomenon in nurses versus other participants. A random sample of 2’860 individuals participated. At one-year follow-up 1’445 questionnaires were returned. At baseline and follow-up, back beliefs were assessed with the Back Beliefs Questionnaire (BBQ) and LBP was assessed using a standardized pain intensity item and pain manikin. Cross-lagged structural equation modeling was used to estimate the prospective risk path from BBQ at baseline to LBP at follow-up. A model comparison test evaluated whether paths differed between 59 nurses and 1’383 other respondents. The cross-lagged path model fitted the empirical data well (CFI = 0.91; RMSEA = 0.04). In nurses, the longitudinal path from BBQ to LBP at follow-up (β=0.30, p=.013) and the cross-sectional association between BBQ and LBP at follow-up (β = 0.42, p = .031) were more positive than in others (longitudinal path: β = 0.05, p = .023; cross-sectional path: β = 0.06, p = .062). The biopsychosocial model of LBP and maladaptive back beliefs should be addressed in educational occupational health interventions for nurses.