Structural relationships of pain intensity and self-efficacy with fear of movement with the mediation of pain catastrophizing and psychological distress in women with rheumatoid arthritis.

The present study was conducted with the aim of determining the relationship between pain intensity and self-efficacy with fear of movement with the mediation of pain catastrophizing and psychological distress in women with rheumatoid arthritis. The statistical population of this study included women with rheumatism referred to the rheumatology clinic of Imam Khomeini Hospital (RA) in Sari city. 224 participants were selected as a sample using the available and purposeful sampling method and answered the questions of Tempa fear of movement scale (Corey et al., 1990), brief pain intensity questionnaire (Cleland, 1991), pain self-efficacy questionnaire ( Nicholas, 1989), the Pain Catastrophizing Scale (Sullivan et al., 1995) and the Psychological Distress Scale (Laviband & Laviband, 1995). Data analysis using structural equation modeling showed that pain intensity has a direct effect on fear of movement (p<0.05, β=0.32); Self-efficacy has a direct effect on fear of movement (p<0.05, β=0.42); Pain catastrophizing has a direct effect on fear of movement (p<0.05, β=0.74); Psychological distress has a direct effect on fear of movement (p<0.05, β=0.78). As a result, the model of fear of movement based on pain intensity and self-efficacy is suitable with the mediation of pain catastrophizing and psychological distress in women with rheumatoid arthritis. The findings of this study prove the importance of psychological interventions in reducing physical symptoms in chronic diseases.