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Wilson-Cleary Model

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The Wilson-Cleary model consists of five major levels: biological and physiological factors, symptom status, functional status, general health perceptions, and overall QOL (Figure 5). The first four components of this model will be discussed here since this thesis investigated SRH for LBP patients. Biological and physiological factors Biological and physiological factors refer to the function of cells, organs, and organ system118. Recently, Briggs et al (2013)129 found that people who have elevated level of C-reactive protein (> 3.0 mg/dL) had greater odds of reporting LBP, especially obese people with odd ratios. Höfelmann and Blank (2008)130 found a strong association between chronic diseases and SRH among Brazilian workers. Importantly, …show more content…

MSK pain sufferers who have depression or anxiety had lower SRH than who do not have psychological issues133,134. Further, depression has a negative impact on SRH among individuals with chronic LBP135 and individuals with chronic pain136. Other studies showed non-significant correlation between psychological symptoms and SRH for chronic LBP137,138. In addition, pain intensity and pain chronicity were significantly associated with the deterioration of physical and the mental function overtime139. Moreover, chronicity of pain, depression and anxiety, and pain related to social difficulty were significant predictors of the physical function140. Functional status Functional status refers to individual performance of specific tasks118. Muraki et al (2010)141 found that LBP was significantly associated with poor physical function. Furthermore, poor SRH is significantly correlated with physical function and mental well-being142,143. Daily activity level is significantly associated with both SRH and LBP144, with physically active people being more likely to have lower prevalence of LBP than less active individuals145. The nature and intensity of physical activity was found in a systematic review to be very important factor on the occurrence of the LBP146. Characteristics of the

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