• Yusuke Karasawa, Keiko Yamada, Masako Iseki, Masahiro Yamaguchi, Yasuko Murakami, Takao Tamagawa, Fuminobu Kadowaki, Saeko Hamaoka, Tomoko Ishii, Aiko Kawai, Hitoshi Shinohara, Keisuke Yamaguchi, and Eiichi Inada.
• Department of Pain Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
• Plos One. 2019 Jan 1; 14 (4): e0215404.

PurposeThis study aimed to investigate whether changes in psychosocial factors and pain severity were associated with reduction in disability due to pain among patients with chronic pain. We hypothesized that increased self-efficacy would reduce disability.Patients And MethodsThis longitudinal observational study included 72 patients. Patients' psychological and physical variables were assessed before and after 3 months of treatment. Demographic and clinical information were collected, including the Pain Disability Assessment Scale (PDAS), the Pain Self-Efficacy Questionnaire (PSEQ), the Hospital Depression and Anxiety Scale, and the Numeric Rating Scale (NRS) to assess pain intensity. First, univariate regression analyses were conducted to clarify associations between change in PDAS and sex, age, pain duration, changes in psychosocial factors (self-efficacy, anxiety, and depression) and change in pain intensity. Second, multivariate regression was conducted using the variables identified in the univariate analyses (PSEQ and NRS) to detect the most relevant factor for reducing disability.ResultsUnivariate regression analyses clarified that changes in PSEQ (β = -0.31; 95% CI: -0.54--0.08, p = 0.008) and NRS (β = 0.24; 95% confidence interval [CI]: 0.01-0.47, p = 0.04) were associated with reduction in PDAS. Multivariate regression analysis demonstrated that change in PSEQ (β = 0.26; 95% CI: -0.50--0.02; p = 0.01) was associated with a reduction in disability, independent of change in NRS.ConclusionThese findings suggest improved self-efficacy is associated with reduced disability in patients with chronic pain, independent of reduction in pain intensity. Focusing on improvement in self-efficacy may be an effective strategy in chronic pain treatment in addition to pain relief.

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