Mestring, sosioøkonomisk status og subjektive helseplager hos pasienter med uspesifikke ryggplager

Background: According to the cognitive activation theory of stress, sustained activation due to lack of positive response outcome expectancies, may lead to bad health and subjective health complaints. Sensitization mechanisms may together with lack of positive response expectancies lead to comorbidity. Combination of sensitization and lack of positive response expectancies can as well lead to sustained complaints and pain. Objective: The aim of this thesis was to investigate relationships between coping, socioeconomic status (education and physical work environment) and subjective health complaints. Methods: This investigation is based on baseline data from 427 patients on sick leave for back pain. The data was collected as a part of a longitudinal randomized controlled multicentre study. Results: The prevalence of subjective health complaints, e.g. musculoskeletal pain, tiredness, and depression was high. Individuals that reported a high score on instrumental mastery oriented coping had a significantly lower level of subjective health complaints. Individuals with a high score on depressive coping style had more subjective health complaints compared to individuals with a low score on depressive coping style. Instrumental mastery oriented coping explained some part of the variance in pseudoneurological complaints. There was a positive relationship between high education and active coping. There was also a positive relationship between physical work environment and subjective health complaints. Conclusions: Comorbidity of subjective health complaints were localized around the spine, as well as head and feet. This indicates that the suggested muscle syndrome has a high prevalence amongst patients with unspecific back pain. The relationship between instrumental coping and subjective health complaints shows the significance of positive response expectancies. The results indicate importance of individually directed actions, especially to groups of people belonging to the lower socioeconomic classes