The mediation of disability by self efficacy in different samples of chronic pain patients

Arnstein, Paul

doi:10.1080/09638280050200296

Cited by 142 publications

(118 citation statements)

References 75 publications

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“…Despite a small number of studies, evidence from this review supports selfefficacy as a mediator in explaining the development of disability from LBP and neck pain. This finding is consistent with the evidence from mixed chronic pain populations [2,3], which suggests that the mediating effect of self-efficacy may be generalizable to other painful conditions. It is notable that systematic reviews in other areas of healthcare consistently identify self-efficacy as a significant mediator for interventions aimed at behaviour change, for example, dietary behaviour change [15], physical activity promotion [52], and obesity prevention [74].…”

Section: A C C E P T E Dsupporting

confidence: 82%

How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain

Lee

Hübscher

Moseley

et al. 2015

Pain

386

288

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Disability is an important outcome from a clinical and public health perspective. However, it is unclear how disability develops in people with low back pain or neck pain. More specifically, the mechanisms by which pain leads to disability are not well understood. Mediation analysis is a way of investigating these mechanisms by examining the extent to which an intermediate variable explains the effect of an exposure on an outcome. This systematic review and meta-analysis was aimed to identify and examine the extent to which putative mediators explain the effect of pain on disability in people with low back pain or neck pain. Five electronic databases were searched. We found 12 studies (N=2,961) that examined how pain leads to disability with mediation analysis. Standardized regression coefficients (â) of the indirect and total paths were pooled. We found evidence to show that self-efficacy (â = 0.23, 95% CI = 0.10-0.34), psychological distress (â = 0.10, 95% CI = 0.01-0.18), and fear (â = 0.08, 95% CI = 0.01-0.14) mediated the relationship between pain and disability, but catastrophizing did not (â = 0.07, 95% CI = -0.06-0.19). The methodological quality of these studies was low and we highlight potential areas for development. Nonetheless, the results suggest that there are significant mediating effects of self-efficacy, psychological distress, and fear, which underpins the direct targeting of these constructs in treatment.

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Section: A C C E P T E Dsupporting

confidence: 82%

How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain

Lee

Hübscher

Moseley

et al. 2015

Pain

386

288

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“…Still, pain-related fear at T2 was significantly predicted by pain intensity at T1 and associated with higher pain-related disability at T2, which is congruent with previous research (e.g., Arnstein, 2000;Costa et al, 2011;Kori, et al, 1990;Vlaeyen et al, 1995).…”

Section: Pain-related Self-efficacy Mediates the Buffering Effects Ofsupporting

confidence: 81%

“…Pain-related self-efficacy is a key determinant of pain behaviors and has been described as the degree of self-confidence to function despite pain and in expending efforts to persist in face of obstacles and aversive experiences (Nicholas, 2007;Turk & Monarch, 2013). High levels of pain-related self-efficacy have been associated with efforts to actively deal with pain (e.g., Turk and Okifuji, 2002) and lower levels of pain intensity, disability, depression and anxiety (e.g., Arnstein, 2000;Costa et al, 2011;Nicholas, 2007;Denison et al, 2007). Furthermore, it has been shown that pain intensity reduces pain-related self-efficacy, leading to higher levels of pain-related disability (e.g., Costa et al, 2011;Schulz et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults’ chronic pain experiences.

Matos¹,

Bernardes²,

Goubert³

et al. 2017

Health Psychology

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Objective: This longitudinal study aimed to investigate: (1) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain, and (2) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. Methods:One hundred and seventy older adults (M age =78.0; SD=8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with three measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire and the Tampa Scale of Kinesiophobia. Results: Using Structural Equation Modelling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. Conclusions:These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related selfefficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain, on older adults' healthy ageing process, are discussed.

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“…Fear of movement / (re)-injury and selfefficacy have emerged as important factors regarding function and disability, especially in patients with low back pain [48;49], and this study adds information about the contribution of these factors in perception of increased pain during activity. It is discussed whether some patients become disabled partly because of low self-efficacy beliefs; the person's doubt in own ability becomes a self-fulfilling prophecy [48]. The data in this study bring some support to the notion that trust in own ability to manage pain influences a person's perceived pain and render it less threatening.…”

Section: Associations Between Psychological Factors Pain Variables Asupporting

confidence: 61%

Activity-related pain in patients with chronic musculoskeletal disorders

Damsgård

Thrane²,

Anke

et al. 2010

Disability and Rehabilitation

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Northern Norway. E-Mail: Elin.Damsgard@fagmed.uit.no 1 AbstractPurpose. Activity related pain may be a barrier to rehabilitation in patients with chronic musculoskeletal disorders. This study investigated patients' reports of increased pain during activity, and the association between such pain and psychological factors and pain variables.Method. Questionnaires from 232 adults with chronic musculoskeletal pain measured pain intensity, spread of pain and pain duration. Pain during activity was assessed both on a 11 point Numeric Rating Scale (NRS), and operationalized as a dichotomous measure, where responders defined if they experienced pain during general activity and exercise.Psychological factors were measured by the Hopkins Symptom Check List 25, the Tampa Scale for Kinesiophobia and a subscale of the Arthritis Self -Efficacy Scale. Multiple and logistic regression was used to analyse associations between increased pain during activity and associated variables.Results. Increased pain during activity was reported by 69 % of participants. Fear of movement was a significant factor for reporting increased pain during activity, both general activity and exercise, also in a subsample with low psychological distress. Other significant factors were spread of pain and a low sense of self efficacy. Conclusion.Patients with high fear of movement, large spread of pain and low self efficacy were more likely to report increased pain during activity even in the absence of psychological distress.2

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The mediation of disability by self efficacy in different samples of chronic pain patients

Abstract: Self efficacy in an important variable contributing to the disability of chronic pain patients. Therefore, evaluating and bolstering the patient's belief in their own abilities may be an important component of therapy.

Cited by 142 publications

References 75 publications

How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain

How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults’ chronic pain experiences.

Activity-related pain in patients with chronic musculoskeletal disorders

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