title: Associations between pain control self-efficacy, self-efficacy for communicating with physicians, and subsequent pain severity among cancer patients.
abstract: OBJECTIVE
  Coaching patients to be more active in health encounters may improve communication with physicians but does not necessarily improve health outcomes. We explored this discrepancy by examining relationships between self-efficacy for communicating with physicians and pain control self-efficacy and subsequent pain severity among cancer patients participating in a coaching trial.
  
  
  METHODS
  We analyzed data from 244 English-speaking adults with various cancer types reporting significant pain, recruited from 49 oncology physicians' offices. Mixed model linear regression examined relationships between post-intervention communication self-efficacy and pain control self-efficacy and subsequent pain severity over 12 weeks.
  
  
  RESULTS
  Post-intervention pain control self-efficacy (but not communication self-efficacy) was significantly related to subsequent pain severity: a one standard deviation increase was associated with a 0.19 point decrease (95% confidence interval=-0.33, -0.04; p=0.01) in pain severity over time, approximately 25% of the effect size of the influence of post-intervention pain on subsequent pain.
  
  
  CONCLUSIONS
  Among cancer patients enrolled in a coaching trial, post-intervention pain control self-efficacy, but not communication self-efficacy, was significantly related to subsequent pain severity.
  
  
  CONCLUSIONS
  Identifying behavioral mediators of cancer pain severity may lead to coaching interventions that are more effective in improving cancer pain control.
authors.affiliation: Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817, USA. afjerant@ucdavis.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003142:Communication; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010146:Pain / Q000517:prevention & control* / Q000523:psychology*; D010147:Pain Measurement; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011446:Prospective Studies; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome