title: Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis.
abstract: OBJECTIVE
  To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.
  
  
  METHODS
  Persons with rheumatoid arthritis for at least four years ( n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.
  
  
  RESULTS
  A direct negative association between pain and performance of valued life activities was identified ( Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.
  
  
  CONCLUSIONS
  These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.
authors.affiliation: 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Ahlstrand
authors.affiliation: 2 School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Vaz
authors.affiliation: 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.|3 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Falkmer
authors.affiliation: 4 Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Thyberg
authors.affiliation: 5 Department of Rheumatology and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: Mathilda
authors.initials: M
authors.lastname: Björk
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000523:psychology*; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D018570:Risk Assessment; D020377:Self Efficacy; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Disability; ICF; mediation; pain; personal factors; rheumatoid arthritis; structural equation modelling; valued life activities scale