Self-Management Behaviors for Chronic Low Back Pain in Patients with Spinal Disease: A Structural Equation Modeling Analysis

Abstract

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management behavior in patients with chronic low back pain based on the results of previous studies and a literature review. Methods: Data from 218 outpatients with spinal disease who visited a university hospital from January 21 to August 3, 2021 with chronic back pain that had lasted for more than 3 months were collected and analyzed. Results: The goodness-of-fit of the final model satisfied recommendations (RMR=.01, RMSEA=.07, GFI=.97, NFI=.95, TLI=.92, CFI=.97). Negative illness perception directly and negatively influenced self-management behavior (β=-.15, p=.021), and also indirectly affected self-management behavior through self-efficacy (β=-.07, p=.007). Positive illness perception directly exerted a positive impact on self-management behavior. Active participation, internal health control, and self-efficacy all directly influenced self-management behavior. Conclusion: In order to improve self-management behavior in patients with chronic low back pain and spinal diseases, it is crucial to first determine whether the patient's perception of their illness is positive or negative. Patients should be encouraged to adopt a positive attitude towards their condition and to persist with self-management.