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Common Health Problems, Yellow Flags and Functioning in a Community Setting

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Abstract

Introduction Common health problems such as pain, depression and fatigue have a high impact on daily life, work and healthcare utilization. This study aimed to investigate the prevalence of these complaints in a UK community setting and to establish whether psychosocial risk factors, or ‘yellow flags’, moderate their impact on daily life and work. Methods 580 women and 420 men participated in a cross-sectional survey in the UK in 2007. 467 (57.2%) of the 816 working age adults in this sample reported complaints over the last month and were included in the moderator multivariate analysis. Results Women and the not employed group reported a higher number and greater extent (frequency × severity) of complaints. Statistically significant models emerged for interference with daily life (F9,457 = 36.54, P < 0.001, adjusted R2 = 0.407) and time off work (F4,462 = 31.22, P < 0.001, adjusted R2 = 0.213). Age (β = .238) and socio-economic status (β = −.216) were associated with time off work. Extent of complaints and number of yellow flags were independently associated with interference with daily life (extent β = .25, yellow flags β = .15) and time off work (extent β = .154, yellow flags β = .201). No moderating effect of yellow flags was found. Conclusions Common health problems and yellow flags can be briefly and simply assessed. A broader approach is needed in managing these complaints in community and work contexts, moving beyond reducing complaint severity. Interventions need to acknowledge and address people’s beliefs and affective responses to complaints, as well as wider socio-economic issues.

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References

  1. Eriksen HR, Svendsrod R, Ursin G, Ursin H. Prevalence of subjective health complaints in the Nordic European countries in 1993. Eur J Pub Health. 1998;8(4):294–8.

    Article  Google Scholar 

  2. Eriksen HR, Ursin H. Sensitization and subjective health complaints. Scand J Psychol. 2002;43(2):189–96.

    Article  PubMed  Google Scholar 

  3. Eriksen HR, Ursin H. Subjective health complaints, sensitization, and sustained cognitive activation (stress). J Psychosom Res. 2004;56(4):445–8.

    Article  CAS  PubMed  Google Scholar 

  4. Ihlebaek C, Eriksen HR. Occupational and social variation in subjective health complaints. Occup Med Oxf. 2003;53(4):270–8.

    Article  PubMed  Google Scholar 

  5. Wilhelmsen I, Mulindi S, Sankok D, Wilhelmsen AB, Eriksen HR, Ursin H. Subjective health complaints are more prevalent in Maasais than in Norwegians. Nord J Psychiatry. 2007;61(4):304–9.

    Article  PubMed  Google Scholar 

  6. van der Windt DAWM, Dunn KM, Spies-Dorgelo MN, Mallen CD, Blankenstein AH, Stalman WAB. Impact of physical symptoms on perceived health in the community. J Psychosom Res. 2008;64:265–74.

    Article  PubMed  Google Scholar 

  7. Aylward M, Sawney P. Support and rehabilitation: restoring fitness for work. In: Palmer KT, Cox RAF, Brown I, editors. Fitness for work: the medical aspects. 4th ed. Oxford: Oxford University Press; 2007.

  8. Gill D, Sharpe M. Frequent consulters in general practice—the effects of psychological well-being and contact with the doctor. J Psychosom Res. 1999;47(2):115–30.

    Article  CAS  PubMed  Google Scholar 

  9. Stanley I, Salmon P, Peters S. Doctors and social epidemics: the problem of persistent unexplained physical symptoms, including chronic fatigue. Br J Gen Pract. 2002;52(478):355–6.

    PubMed  Google Scholar 

  10. Waddell G, Aylward M. The scientific and conceptual basis of incapacity benefits. London: TSO; 2005.

    Google Scholar 

  11. Waddell G, Burton AK. Is work good for your health and well-being?. London: TSO; 2006.

    Google Scholar 

  12. Main CJ, Watson PJ, Sullivan MJL. Pain management: practical applications of the biopsychosocial perspective in clinical and occupational settings: Churchill Livingstone; 2007.

  13. Kendall NAS, Linton SJ, Main CJ. Guide to assessing psychosocial yellow flags in acute low back pain: risk factors for long term disability and work loss. Wellington, NZ: Accident Rehabilitation and Compensation Insurance Corporation of New Zealand and the National Health Committee 1997.

  14. Vlaeyen J, Linton S. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85:317–32.

    Article  CAS  PubMed  Google Scholar 

  15. Leeuw M, Goossens M, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30(1):77–94.

    Article  PubMed  Google Scholar 

  16. Garnefski N, Kraaij V. Relationships between cognitive emotion regulation strategies and depressive symptoms: a comparative study of five specific samples. Pers Individ Differ. 2006;40(8):1659–69.

    Article  Google Scholar 

  17. Nijs J, Meeus M, De Meirleir K. Chronic musculoskeletal pain in chronic fatigue syndrome: recent developments and therapeutic implications. Man Ther. 2006;11(3):187–91.

    Article  PubMed  Google Scholar 

  18. Ellis J, Hampson SE, Cropley M. The role of sleep catastrophizing in attributions for poor sleep amongst late-life insomniacs. Sleep Med. 2007;8:277–80.

    Article  PubMed  Google Scholar 

  19. McCracken L, Eccleston C. Coping or acceptance: what to do about chronic pain? Pain. 2003;105:197–294.

    Article  PubMed  Google Scholar 

  20. McCracken L, Vowles K. A prospective analysis of acceptance of pain and values-based action in patients with chronic pain. Health Psychol. 2008;27(2):215–20.

    Article  PubMed  Google Scholar 

  21. McCracken L, MacKichan F, Eccleston C. Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change. Eur J Pain. 2007;11(3):314–22.

    Article  PubMed  Google Scholar 

  22. Cioffi D. Beyond attentional strategies: a cognitive-perceptual model of somatic interpretation. Psychol Bull. 1991;109:25–41.

    Article  CAS  PubMed  Google Scholar 

  23. Robbins JM, Kirmayer LJ. Attributions of common somatic symptoms. Psychol Med. 1991;21(4):1029–45.

    Article  CAS  PubMed  Google Scholar 

  24. Leventhal H, Leventhal EA, Contrada RJ. Self-regulation, health, and behavior: a perceptual-cognitive approach. Psychol Health. 1998;13(4):717–33.

    Article  Google Scholar 

  25. Leventhal H, Nerenz DR, Steele DF. Illness representations and coping with health threats. In: Baum A, Singer J, editors. A handbook of psychology and health. Hillsdale: Erlbaum; 1984. p. 219–52.

    Google Scholar 

  26. Laaksonen M, Aittomaki A, Lallukka T, Rahkonen O, Saastamoinen P, Silventoinen K, et al. Register-based study among employees showed small nonparticipation bias in health surveys and check-ups. J Clin Epidemiol. 2008;61(9):900–6.

    Article  PubMed  Google Scholar 

  27. Vagero D, Kislitsyna O, Ferlander S, Migranova L, Carlson P, Rimachevskaya N. Moscow Health Survey 2004—social surveying under difficult circumstances. Int J Public Health. 2008;53(4):171–9.

    Article  PubMed  Google Scholar 

  28. Joffe M. Male- and female-mediated reproductive effects of occupation: the use of questionnaire methods. J Occup Med. 1989;31(12):974–9.

    Article  CAS  PubMed  Google Scholar 

  29. Barnes MC, Buck R, Williams G, Webb KL, Aylward M. Beliefs about common health problems and work: a qualitative study. Soc Sci Med. 2008;64(4):657–65.

    Article  Google Scholar 

  30. Ursin H, Endersen IM, Ursin G. Psychological factors and self-reports of muscle pain. Eur J Appl Physiol. 1988;57:282–90.

    Article  CAS  Google Scholar 

  31. Eriksen HR, Hellesnes B, Staff P, Ursin H. Are subjective health complaints a result of modern civilization? Int J Behav Med. 2004;11(2):122–5.

    Article  PubMed  Google Scholar 

  32. Sullivan M, Bishop S, Pivik J. The Pain Catastrophization Scale: development and validation. Psychol Assess. 1995;7:524–32.

    Article  Google Scholar 

  33. Asmundson GJG, Norton PJ, Norton GR. Beyond pain: the role of fear and avoidance in chronicity. Clinical Psychology Review 1999.

  34. McCracken L. “Attention” to pain in persons with chronic pain: a behavioural approach. Behav Ther. 1997;28(2):271–84.

    Article  Google Scholar 

  35. McCracken L. Learning to live with pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain. 1998;74:21–7.

    Article  CAS  PubMed  Google Scholar 

  36. ONS. The national office of statistics socio-economic classification user manual. New York: Palgrave Macmillan; 2005.

    Google Scholar 

  37. Sigmon ST, Pells JJ, Boulard NE, Whitcomb-Smith S, Edenfield TM, Hermann BA, et al. Gender differences in self-reports of depression: the response bias hypothesis revisited. Sex Roles. 2005;53(5–6):401–11.

    Article  Google Scholar 

  38. Tesch-Romer C, Motel-Klingebiel A, Tomasik MJ. Gender differences in subjective well-being: comparing societies with respect to gender equality. Soc Indic Res. 2008;85(2):329–49.

    Article  Google Scholar 

  39. Phillips CJ, Main CJ, Buck R, Aylward M, Wynne-Jones G, Farr A. Prioritising pain in policy making: the need for a whole systems perspective. Health Policy. 2008;88(2–3):166–75.

    Article  PubMed  Google Scholar 

  40. World Health Organization. The global burden of disease: 2004 Update. Geneva 2008.

  41. Eccleston C. Chronic pain and attention—a cognitive approach. Br J Clin Psychol. 1994;33:535–47.

    PubMed  Google Scholar 

  42. MacLeod AK, Haynes C, Sensky T. Attributions about common bodily sensations: their associations with hypochondriasis and anxiety. Psychol Med. 1998;28(1):225–8.

    Article  CAS  PubMed  Google Scholar 

  43. Sensky T, MacLeod AK, Rigby MF. Causal attributions about common somatic sensations among frequent general practice attenders. Psychol Med. 1996;26(3):641–6.

    Article  CAS  PubMed  Google Scholar 

  44. Butler JA, Chalder T, Wessely S. Causal attributions for somatic sensations in patients with chronic fatigue syndrome and their partners. Psychol Med. 2001;31(1):97–105.

    Article  CAS  PubMed  Google Scholar 

  45. Kirmayer LJ, Groleau D, Looper KJ, Dao MD. Explaining medically unexplained symptoms. Can J Psychiatry. 2002;49(10):663–72.

    Google Scholar 

  46. Waddell G, Burton AK, Main CJ. Screening to identify people at risk of long-term incapacity for work. London: The Royal Society of Medicine Press Ltd; 2003.

    Google Scholar 

  47. Buck R, Wynne-Jones G, Varnava A, Main CJ, Phillips CJ. Working with musculoskeletal pain. Reviews in pain. 2009;3(1):6–10.

    Google Scholar 

  48. Johnston O, Kumar S, Kendall K, Peveler R, Gabbay J, Kendrick T. Qualitative study of depression management in primary care: GP and patient goals, and the value of listening. Br J Gen Pract. 2007;57(544):872–9.

    Article  PubMed  Google Scholar 

  49. Fink P, Rosendal M. Recent developments in the understanding and management of functional somatic symptoms in primary care. Curr Opin Psychiatry. 2008;21(2):182–8.

    Article  PubMed  Google Scholar 

  50. Breen A, Austin H, Campion-Smith C, Carr E, Mann E. “You feel so hopeless”: a qualitative study of GP management of acute back pain. Eur J Pain. 2007;11(1):21–9.

    Article  PubMed  Google Scholar 

  51. Verbeek J, Sengers MJ, Riemens L, Haafkens J. Patient expectations of treatment for back pain: a systematic review of qualitative and quantitative studies. Spine. 2004;29(20):2309–18.

    Article  PubMed  Google Scholar 

  52. Waddell G. Preventing incapacity in people with musculoskeletal disorders. Br Med Bull. 2006;77–78:55–69.

    Article  PubMed  Google Scholar 

  53. Buchbinder R, Jolley D, Wyatt M. Effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice. Spine. 2001;26(23):2535–42.

    Article  CAS  PubMed  Google Scholar 

  54. Jorm AF, Christensen H, Griffiths KM. The impact of beyondblue: the national depression initiative on the Australian public’s recognition of depression and beliefs about treatment. Aust NZ J Psychiatry. 2005;39:248–54.

    Google Scholar 

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Acknowledgments

The research centre where this work was carried out is sponsored in part by a grant from Unum Ltd. The authors wish to express their thanks to Alice Varnava and Katie Webb for their assistance with the piloting the survey and coding the qualitative data, and to Mike Robling and Kerry Hood for their comments during the development of the survey.

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Authors and Affiliations

  1. Centre for Psychosocial and Disability Research, School of Psychology, Cardiff University, Cardiff, Wales, UK

    Rhiannon Buck, Maria C. Barnes, Debbie Cohen & Mansel Aylward

  2. Mental Health Research and Development Unit, School for Health, University of Bath, Bath, BA2 7AY, UK

    Rhiannon Buck

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  1. Rhiannon Buck
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Correspondence to Rhiannon Buck.

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Buck, R., Barnes, M.C., Cohen, D. et al. Common Health Problems, Yellow Flags and Functioning in a Community Setting. J Occup Rehabil 20, 235–246 (2010). https://doi.org/10.1007/s10926-009-9228-6

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