Analysis of influencing factors of low back dysfunction in young and middle-aged patients with lumbar disc herniation undergoing conservative management

ObjectiveTo understand the degree of low back dysfunction in young and middle-aged patients with lumbar disc herniation (LDH) undergoing conservative management, analyze the relationship between disease self-management behavior, fear avoidance belief and dysfunction, and explore the influencing factors of low back dysfunction.

MethodsA total of 248 young and middle-aged patients with LDH undergoing conservative management were selected as the study subjects by convenient sampling method.The general demography and case data of the patients were collected, and the patients were investigated by visual analogue scale (VAS), chronic disease self-management scale (CDSMS), fear avoidance belief questionnaire (FABQ) and Oswestry dysfunction index (ODI).The correlation between CDSMS, FABQ, and ODI in young and middle-aged LDH patients, as well as the influencing factors of lower back dysfunction were analyzed.

ResultsThe total ODI score of young and middle-aged LDH patients was (23.26±6.39) points, patients with moderate, severe, and extremely severe dysfunction accounted for 36.29%, 48.39% and 15.32%, respectively, and there were no patients with mild dysfunction and bed-restricted rest.There were statistically significant differences in ODI scores among patients with different genders, age, exercise frequency, body mass index, health status of self-assessment, use of analgesics, pain site, and pain severity (P<0.01).The scores of CDSMS in all dimensions of young and middle-aged LDH patients were significantly negatively correlated with the total score of ODI (P<0.01), and the scores of FABQ in all dimensions were significantly positively correlated with the total score of ODI (P<0.01).Gender, age, body mass index, use of analgesics, disease self-management behavior and fear avoidance belief were the main influencing factors of dysfunction (P<0.01), which could explain 76.10% of the total variation of ODI.

ConclusionsYoung and middle-aged patients with LDH undergoing conservative management have more severe low back dysfunction and obvious pain.Disease self-management behavior and fear avoidance belief are associated with dysfunction.Nursing staff should actively carry out health education and targeted intervention to improve patients' disease self-management ability and pain coping belief, so as to reduce the degree of low back dysfunction.