Self-Management Among Adults with Chronic Low Back Pain: A Causal Model

Chronic low back pain is a common musculoskeletal problem and requires self-management among adults to carry out an active and emotionally satisfying life. To support self-management, it is necessary to understand how various factors work to influence this. The objective of this study was to develop a causal model of self-management among adults with chronic low back pain. A total of 174 Thai adults with chronic low back pain aged between 30 - 60 years were randomly selected by a multi-stage sampling method from four hospitals in the northern region of Thailand. Data were collected via the following instruments: The Demographic Data Form, Self-Management Scale, Modified Self-Efficacy for Chronic Low Back Pain Management Scale, Low Back Pain Knowledge Questionnaire, Modified Barthel's Activity of Daily Living Index, Chula Activity of Daily Living Index, Social Support Questionnaire, and Belief in Treatment Effectiveness Scale. Data were analyzed by descriptive statistics, Pearson's product moment correlation, and path analysis. The results revealed that overall self-management was at a moderate level. A causal model of self-management fitted with data, and was able to explain 33.00% of the variance in self-management by four factors. These factors, self-efficacy, social support, low back pain knowledge, and belief in treatment effectiveness directly affected self-management. Social support both directly and indirectly affected self-management through self-efficacy and belief in treatment effectiveness. These results indicate that nurses can use the four factors to conduct appropriate interventions for promoting self-management among adults with chronic low back pain.