Text Network Analysis of Global Literature on Self-Management of Low Back Pain

To identify the knowledge structure of low back pain (LBP) self-management literature by developing schematic diagrams of keyword relationships from a macro perspective, while examining research topics and trends across time and income.

A quantitative content analysis.

This study employed text network analysis to explore keywords and research topics using topic modeling. Relevant articles were retrieved from PubMed, Embase, and Cochrane up to May 2023, and keywords were analyzed using NetMiner 4.3.3.

From 1977 to May 2023, 3,712 articles were published. In the knowledge structure, the keywords "pain," "patient," and "LBP" were highly linked to other keywords, forming their respective clusters. Six topics emerged: symptoms and mental comorbidities in chronic LBP, work-related risk, exercise-based self-management program, medication treatment, surgical treatment, and provider-delivered care. The studies varied depending on the country's income level.

This study demonstrated that self-management is a key component of the recommended clinical practice guidelines for LBP, highlighting its critical role in patients' rehabilitation and recovery. However, research on the associated psychosocial and biological components and studies applying self-management theories remains limited, underscoring the need for further investigation. Furthermore, research on appropriate care for LBP in low-income countries is required.

Nurses play a leading role in educating patients with LBP on self-management, particularly in hospital settings, focusing on processes that support their return to work and daily activities. Therefore, nurses are well-positioned to advance evidence-based nursing practices, ensuring high-quality, patient-centered care in clinical settings.