A structural equation modeling investigation of psychological distress with quality of life in functional dyspepsia: The mediating role of pain self-efficacy, visceral sensitivity, pain-related mental imagery, and pain catastrophizing

The research has shown that the psychological distress is an important risk factor in pathogenesis of the functional dyspepsia. It severely affects the quality of patients’ life regarding psychological processes in the field of pain and visceral stimuli. However, there is a lack of structural models among the literature for predicting the quality of life based on psychological distress considering the effect of mediating roles of pain self-efficacy, visceral sensitivity, pain-related mental imagery, and pain catastrophizing.

The purpose of this study is investigating the relationship between the psychological distress and the quality of life in functional dyspepsia considering the effect of the mediating roles of pain self-efficacy, visceral sensitivity, pain-related mental imagery, and pain catastrophizing.

The method used in this research is the model of “correlation of structural equation modeling”. The statistical population of the model consists of 363 patients with functional dyspepsia who referred to gastrointestinal clinics in Isfahan selected using the “convenience sampling method”. Nepean dyspepsia index (Talley et al., 1999), depression, anxiety and stress scale (Sahebi et al., 2005), chronic pain self-efficacy questionnaire (Besharat, 1387), short form -McGill pain questionnaire (Kachooei et al., 1394), visceral sensitivity index (Pourtavakoli et al., 1397) and pain catastrophizing scale (Sajjadian et al., 1391) are used to acquire data. The data are analyzed using the developed structural equation model and the smart-PLS software.

The results obtained by the developed model shows a strong overall fit (GOF= 0.857) and the general structure of the tested relationships is confirmed by the obtained data (NFI= 0.907 and SRMR= 0.056). All indirect coefficients in the model are considered as significant with t≥ 1.96 and p≤ 0.05. Also, all direct coefficients are significant excepts the direct effect between the quality of life and both the visceral sensitivity and the pain self-efficacy with t≥ 1.96 and p≤ 0.05.

The results of the present research demonstrate that the quality of life has significant relations to the psychological distress through pain self-efficacy, visceral sensitivity, pain-related mental imagery, and pain catastrophizing. The findings of this model help to understand the effect of psychological distress on the quality of life of patients with functional dyspepsia and considering these relationships can be of great importance in the etiology and treatment of patients.