Abstract
BackgroundMany factors are proposed to be associated with health-related quality of life. Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. The aim of this study was to investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain in a cohort from a general population.MethodsThe study was designed as a longitudinal study in a Swedish general population (N = 1 849) with a postal questionnaire at baseline 1995 and at follow up 2003. Subjects were divided into two groups, according to their response about chronic musculoskeletal pain at baseline. Health-related quality of life was assessed by the SF-36 together with suggested health factors. The associations between SF-36 subscales and suggested health factors were estimated by OR and 95% CI calculated by multivariable logistic regressions, with adjustment for all health factors, age, sex and baseline SF-36 values.ResultsAlthough subjects without chronic musculoskeletal pain reported better health-related quality of life than subjects with chronic pain, similar health factors were found to be associated to higher scores in SF-36 at baseline and predicted a better outcome in the eight-year follow up. The most consistent finding was a better health outcome in the eight-year follow up for subjects that were feeling rested after sleep. Other factors that in some aspects predicted a better outcome were belonging to higher socioeconomic group, being a native Swede, having emotional support, having good sleep structure, never being or being a former smoker, and regularly drinking alcohol.ConclusionThe most important health factor in subjects with and without chronic musculoskeletal pain was feeling rested after sleep, but also emotional support, sleep structure, smoking and alcoholic habits appears to be important components. These health factors could be important to address in clinical work with painful musculoskeletal disorders. Since several health factors are common in both subjects with and without pain there could be a common strategy to be formed in public health programmes.
Highlights
IntroductionKnowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work
Many factors are proposed to be associated with health-related quality of life
Details regarding the distribution of sociodemographic characteristics and suggested health factors with regard to the two groups with and without chronic musculoskeletal pain are found in Additional file 1 (Table 5)
Summary
Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. Knowledge of risk factors as well as changes of attitude and life style in the population is supposed to prevent or reduce the burden of disease [2,3]. In studies of musculoskeletal disorders and health-related quality of life [6,7], the priority has primarily been on risk factors (pathogenesis) instead of the patients' own capacity to adopt factors that promote their health (salutogenesis) [2,3]. Studies primarily looking at risk factors conclude that health could be promoted by several factors, like having a good social network and support, and good work environment [8]. It is important to reduce the use of alcohol [13] and tobacco [14,15]
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