{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T08:31:11Z","timestamp":1774168271279,"version":"3.50.1"},"reference-count":77,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Low back pain (LBP) is a public health problem. General health perception is the best predictor of healthcare utilization and mortality. Identifying predictors of health perception helps understand how people with LBP live, implement the appropriate treatment, and improve the quality of care.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aimed to estimate the relationships between pain intensity, psychological distress, self-efficacy, functional ability, and healthcare utilization among individuals with chronic LBP over a period of six-months and to estimate the impact of these relationships on general health perception.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a secondary analysis of data from a longitudinal study that assessed the health outcomes of individuals with chronic LBP. Structural equation modeling (SEM), based on health frameworks, was used to estimate the predictors of health perception among people with LBP at baseline and 6-months.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>314 individuals with LBP were included in the analysis. The final SEM model had good fit statistics and explained 48% of health perception variance at 6-months. The model showed that health perception was significantly affected by pain intensity (\u03b2\u2009=\u20090.29, \u03b2\u2009=\u20090.21), psychological distress (\u03b2\u2009=\u20090.51, \u03b2\u2009=\u20090.44) and self-efficacy (\u03b2\u2009=\u20090.4, \u03b2\u2009=\u20090.36) cross-sectionally and overtime, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Different health outcomes could affect the health perception among people with low back pain. This requires holistic approaches to treatment, involving self-management and cognitive behavioral therapy, as well as improved self-efficacy to improve their health.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0324101","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T18:00:18Z","timestamp":1748023218000},"page":"e0324101","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Determinants of general health perception among individuals with chronic low back pain overtime: structural equation modeling"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6191-8745","authenticated-orcid":true,"given":"Owis","family":"Eilayyan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Line","family":"Enjalbert-Auneau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"6","key":"pone.0324101.ref001","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1002\/art.34347","article-title":"A systematic review of the global prevalence of low back pain","volume":"64","author":"D Hoy","year":"2012","journal-title":"Arthritis Rheum"},{"issue":"6","key":"pone.0324101.ref002","doi-asserted-by":"crossref","first-page":"299","DOI":"10.21037\/atm.2020.02.175","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"A Wu","year":"2020","journal-title":"Ann Transl Med"},{"issue":"3","key":"pone.0324101.ref003","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/pm\/pny062","article-title":"Pain Intensity, Disability, and Quality of Life in Patients with Chronic Low Back Pain: Does Age Matter?","volume":"20","author":"M Wettstein","year":"2019","journal-title":"Pain Med"},{"issue":"2","key":"pone.0324101.ref004","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/S0033-3182(10)70673-3","article-title":"Depression in chronic back pain patients: prediction of pain intensity and pain disability in cognitive-behavioral treatment","volume":"51","author":"JA Glombiewski","year":"2010","journal-title":"Psychosomatics"},{"issue":"13","key":"pone.0324101.ref005","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1097\/01.brs.0000219947.71168.08","article-title":"Comorbid subjective health complaints in low back pain","volume":"31","author":"EM Hagen","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"pone.0324101.ref006","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.pain.2007.01.012","article-title":"The impact of chronic low back pain on older adults: a comparative study of patients and controls","volume":"131","author":"TE Rudy","year":"2007","journal-title":"Pain"},{"issue":"1","key":"pone.0324101.ref007","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11136-019-02302-w","article-title":"The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients","volume":"29","author":"EN Mutubuki","year":"2020","journal-title":"Qual Life Res"},{"issue":"1","key":"pone.0324101.ref008","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3344\/kjp.2019.32.1.22","article-title":"Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain","volume":"32","author":"GM Semeru","year":"2019","journal-title":"Korean J Pain"},{"issue":"1","key":"pone.0324101.ref009","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/s41572-018-0052-1","article-title":"Low back pain","volume":"4","author":"JWS Vlaeyen","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0324101.ref010","article-title":"Prognosis for patients with chronic low back pain: inception cohort study","volume":"339","author":"CM Costa L da","year":"2009","journal-title":"BMJ"},{"issue":"9178","key":"pone.0324101.ref011","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0140-6736(99)01312-4","article-title":"Epidemiological features of chronic low-back pain","volume":"354","author":"GB Andersson","year":"1999","journal-title":"Lancet"},{"key":"pone.0324101.ref012","author":"A Brown","year":"2005"},{"issue":"1","key":"pone.0324101.ref013","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/jama.1995.03520250075037","article-title":"Linking clinical variables with health-related quality of life. 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