• Anthony Jerant, Peter Franks, and Richard L Kravitz.
• Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817, USA. afjerant@ucdavis.edu
• Patient Educ Couns. 2011 Nov 1;85(2):275-80.

ObjectiveCoaching patients to be more active in health encounters may improve communication with physicians but does not necessarily improve health outcomes. We explored this discrepancy by examining relationships between self-efficacy for communicating with physicians and pain control self-efficacy and subsequent pain severity among cancer patients participating in a coaching trial.MethodsWe analyzed data from 244 English-speaking adults with various cancer types reporting significant pain, recruited from 49 oncology physicians' offices. Mixed model linear regression examined relationships between post-intervention communication self-efficacy and pain control self-efficacy and subsequent pain severity over 12 weeks.ResultsPost-intervention pain control self-efficacy (but not communication self-efficacy) was significantly related to subsequent pain severity: a one standard deviation increase was associated with a 0.19 point decrease (95% confidence interval=-0.33, -0.04; p=0.01) in pain severity over time, approximately 25% of the effect size of the influence of post-intervention pain on subsequent pain.ConclusionAmong cancer patients enrolled in a coaching trial, post-intervention pain control self-efficacy, but not communication self-efficacy, was significantly related to subsequent pain severity.Practice ImplicationsIdentifying behavioral mediators of cancer pain severity may lead to coaching interventions that are more effective in improving cancer pain control.Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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