The Mediational Role of Pain Self-Efficacy and Fear of Movement in Explaining the Relationship between Chronic Pain and Disability

There is considerable individual variation in the levels of pain-related disability among people with chronic pain. Pain self-efficacy and fear of movement have been proposed to explain individual differences in the level of pain-related disability. This study aims to investigate whether pain self-efficacy and fear of movement mediate the relationship between pain intensity and disability in patients with chronic pain. In a cross-sectional design, 195 chronic pain patients completed measures for pain intensity, disability, pain self-efficacy and fear of movement. The mean age (SD) of the sample was 45.6 years (12) and 73% of the sample reported their main pain sites as low back and legs. Regression analyses were used to test the mediational hypothesis. The first regression analysis indicated that pain self-efficacy beliefs partially mediated the effects of pain intensity on disability. The results of the Sobel test confirmed this mediational effect (Z = 3.40, p < 0.001). The second regression analysis indicated that fear of movement partially mediated the effect of pain intensity on disability. The results of the Sobel test confirmed this mediational effect (Z = 4.43, p< 0.001). Pain self-efficacy and fear of movement are important in terms of understanding the relationship between pain and disability. The clinical implications of these findings are discussed in the paper.