Biopsychosocial aspects of idiopathic scoliosis

Abstract

This study explored the impact of idiopathic scoliosis on biopsychosocial functioning. A volunteer sample of 167 people with idiopathic scoliosis (n = 126) and parents of children with idiopathic scoliosis (n = 41) completed a postal questionnaire that elicited information on sociodemographics, medical factors and experiences with scoliosis treatment. The questionnaire also included measurement scales to assess the following biopsychosocial variables: (1) perception of discrimination due to appearance and satisfaction with overall appearance during childhood and adolescence (Iowa Body Image Scale); (2) perceived body image (modified version of the Satisfaction and Dissatisfaction with Body Parts Scale); (3) acceptance of scoliosis (modified version of the Acceptance of Illness Scale); (4) health-related quality of life as a function of
psychosocial functioning, problems due to back pain, perceived back flexibility and sleep disturbances (Quality of Life Profile for Spine Deformities); (5) Health Locus of Control (Multi-dimensional Health Locus of Control Scale: Form-C); (6) incidence, location, intensity and subjective quality of pain (McGill Pain Questionnaire); and (7) salient stressors, coping styles and coping functions (Functional Dimensions of Coping Scale). People with scoliosis reported greater discrimination due to their appearance and poorer satisfaction with their overall appearance during adolescence than childhood, including poorer perceptions of body image than parents of children with scoliosis. People with scoliosis scored higher on Internal than External Health Locus of Control and reported some difficultly with adjusting to their condition, day-to-day activities, diminished self-esteem, increased dependency on others and problems related to back
pain. Incidence of pain and use of analgesic medication was unexpectedly high,
although pain intensity was typically mild and quality of scoliosis-related pain was primarily described as a function of the adjectives subsumed within the Evaluative pain rating index on the McGill Pain Questionnaire (annoying, troublesome, miserable, intense or unbearable). Subsequent analyses were based on the sub-sample of 103 adults with scoliosis. Perception of discrimination and satisfaction with appearance during pre-adulthood were associated with body image and health-related quality of life during adulthood, and were influenced by reliance on the coping function of Reappraisal. Body image and health-related quality of life influenced subjective quality and intensity of pain, with the latter moderated by reliance on the coping function of Avoidance. Brace and surgical-treatment had few beneficial biopsychosocial consequences for adults with scoliosis. Adults with scoliosis, parents and students without scoliosis reported differential patterns of stressors, coping styles and coping functions. Adults with scoliosis most frequently reported stressors related to their condition, employment and personal relationships, whereas parents most frequently reported stressors congruent with their social role. Adaptive coping was defined by adults with scoliosis as reliance on the coping styles of emotional and instrumental social support and keeping busy. Functional coping was influenced by age, region of England, marital status, age at onset, type of curve, body image, psychosocial functioning and acceptance of scoliosis. The multidisciplinary management of scoliosis, future research, information provision and psychosocial interventions for biopsychosocial problems experienced by people with scoliosis and their families are discussed.

Date of Award	7 May 2007
Original language	English
Awarding Institution	Teesside University
Supervisor	Paul Van Schaik (Supervisor) & Anna Van Wersch (Supervisor)