Biopsychosocial rehabilitation in the working population with chronic low back pain: a concept analysis

Objective: To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population. Design: A concept analysis was conducted accor-ding to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions. Methods: Five databases were searched, followed by a systematic screening. Subsequently, attribu-tes, illustrative cases, antecedents, consequences and empirical referents were formulated. Results: Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological sup-port, education, personalization, self-management, participation, follow-up, practice standard, goal -set-ting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased fun-ction and work status. Finally, examples of empirical referents were given. Conclusion: This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsycho-social rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personaliza-tion is done.