Entscheidungsbalance und körperliche Aktivität bei Rückenschmerz im Alter – eine Studie im Rahmen des Transtheoretischen Modells

Abstract

Decisional balance and self-efficacy determine readiness for physical activity in the context of the Transtheoretical Model. We asked elderly patients with low back pain which are the barriers and benefits that make up their decisional balance. After adding frequently presented and salient items to complement existing decisional balance scales, we examined the dimensionality and the psychometric properties of the newly developed instrument. A total of 170 elderly patients with a mean age of 70.3 years (SD = 4.4, range 65–83), nearly half of whom had received a diagnosis of spondylosis, participated in diagnostic interviews that included stage of change, decisional balance, self-efficacy, and perceived function (Hanover Functional Disability Scale), as well as an objectively taken measure of mobility. A principal component analysis of the decisional balance items revealed a three-factor-solution with factor I representing the perceived advantages (10 items, α = 0.73), factor II reflecting items that indicate “fear avoidance beliefs” (5 items, α = 0.74), and factor III containing items that may be summarized as “organizational barriers” (5 items, α = 0.65). The construct validity of the scale is supported by the fact that individuals in the pre-contemplation and contemplation stages show higher fear avoidance than those in the preparation and action stages. Moreover, fear avoidance correlates negatively with self-efficacy and subjective and objective measures of physical function. The fear avoidance beliefs scale appears to be useful to supplement the traditional decisional balance scale, although its application may be limited to the study of physical activity in individuals with pain.