title: Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care.
abstract: This study examined the relations between disability, as measured by the Pain Disability Index (PDI) and self-efficacy, fear avoidance variables (kinesiophobia and catastrophizing), and pain intensity, using a prospective design. Two primary health care samples (n(1)=210; n(2)=161) of patients with subacute, chronic or recurring musculoskeletal pain completed sets of questionnaires at the beginning of a physiotherapy treatment period. Multiple hierarchial regression analyses showed that self-efficacy explained a considerably larger proportion of the variance in disability scores than the fear avoidance variables in the first sample. This finding was replicated in the second sample. Pain intensity explained a small, but significant proportion of the variance in disability scores in one sample only. Gender, age, and pain duration were not related to disability. These findings suggest that self-efficacy beliefs are more important determinants of disability than fear avoidance beliefs in primary health care patients with musculoskeletal pain. The findings also suggest that pain-related beliefs, such as self-efficacy and fear avoidance, in turn, are more important determinants of disability than pain intensity and pain duration in these patients.
authors.affiliation: Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala Se-751 83, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Denison
authors.forename: P
authors.initials: P
authors.lastname: Åsenlöf
authors.forename: P
authors.initials: P
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D000368:Aged; D001362:Avoidance Learning / Q000502:physiology; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000502:physiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000503:physiopathology / Q000523:psychology*; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D020377:Self Efficacy