title: Self-efficacy mediates the relation between pain-related fear and outcome in chronic low back pain patients.
abstract: This study aimed to determine whether self-efficacy beliefs mediated the relation between pain-related fear and pain, and between pain-related fear and disability in CLBP patients who exhibited high pain-related fear. In a cross-sectional design, 102 chronic low back pain (CLBP) patients completed measures for pain, disability, self-efficacy and pain-related fear (fear of movement and catastrophizing). Multistep regression analyses were performed to determine whether self-efficacy mediated the relation between pain-related fear and outcome (pain and/or disability). Self-efficacy was found to mediate the relation between pain-related fear and pain intensity, and between pain-related fear and disability. Therefore, this study suggests that when self-efficacy is high, elevated pain-related fear might not lead to greater pain and disability. However, in instances where self-efficacy is low, elevated pain-related fear is likely to lead to greater pain and disability. In view of these findings, we conclude that it is imperative to assess both pain-related fear and self-efficacy when treating CLBP patients with high pain-related fear.
authors.affiliation: Department of Physiotherapy, North Manchester General Hospital, Crumpsall, Manchester, UK. steve.woby@pat.nhs.uk
authors.forename: Steve R
authors.initials: SR
authors.lastname: Woby
authors.forename: Martin
authors.initials: M
authors.lastname: Urmston
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Watson
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D020377:Self Efficacy; D011795:Surveys and Questionnaires