COMPARISON OF TWO KINDS OF HEALTH EDUCATION TO IMPROVE BELIEFS
AND THE DEGREE OF DISABILITY DUE TO BACK PAIN IN THE ELDERLY.
Title.
The effect of two kinds of health education
on the degree of disability and beliefs related to back pain
in the elderly: a controlled clinical trial randomized in
bunches.
Background.
Back pain can limit the life of those suffering
it and produce disability. These disorders may affect more
than 90% of the population over 65 years old and their mistaken
beliefs can constitute an added risk factor to the possibility
of these disorders becoming chronic. Thus for example, the
mistaken belief that encourages bed rest in the case of back
pain may have especially negative consequences in this segment
of the population.
While there are health education programs aimed at the elderly,
usually centered on healthy posture, very few have been scientifically
evaluated, which may bring into question the efficient use
of the funds spent on them.
For that reason, an evaluation was made of the effect of
two different kinds of health education on the degree of disability
and beliefs related to back pain.
Objective.
To evaluate the effect that two different
kinds of health education have on the degree of disability
and beliefs about back pain in the elderly.
Methodology.
It was a controlled clinical trial randomized
by clusters, blind in the randomization, the evaluation and
the analysis of the results. The subjects were blind in regard
to the kind of education they received. There was a 180-day
follow-up.
The study was made in retirement homes and senior residences
in Palma de Mallorca, Asturias and Madrid. In collaboration
with the doctors at the homes and residences, 660 retired
men and women were recruited. Those unable to complete the
measuring instruments used for the variables of evolution
(for example, the pain analog scales, that included, among
others, subjects with functional illiteracy, senility and
blindness), those required to be lying down, diagnosed with
inflammatory rheumatoid illnesses (spondylitis, rheumatoid
arthritis, Reiter illness, psoriatic rheumatism), cancer or
fibromyalgia were excluded.
The sample subjects were randomly divided into three groups.
In all, talks on health education lasting the same amount
of time were given and pamphlets that looked alike in terms
of color and length, etc. handed out. In the patients assigned
to group "A", the talk and pamphlet insisted on
the norms of healthy posture. In group "B" the talk
and pamphlet insisted on maintaining as active an attitude
as possible, to avoid bed rest. In group "C", which
was used as a control group, the talks and pamphlet centered
on diet and cardiovascular health (not referring to back pain).
The evolution of the patients was appraised over one year,
measuring with previously validated instruments their pain
intensity, physical disability (limitations in daily activity),
fear and avoidance beliefs effecting physical activity and
the use of pharmaceutical treatment. These variables were
appraised immediately after the patient entered the study,
and at 30 and 180 days.
Participants, along with the Foundation's
Science Department.
The study was carried out by doctors at the
Kovacs Foundation and was co-funded by the Kovacs Foundation
and the Institute of Migrations and Social Services (IMSERSO).
Status.
Data collection has concluded and data is
being analyzed.
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