Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health in with chronic pain patients.

Purpose: To investigate the interactions between self-efficacy - including subcomponents - and symptoms (pain, depression and anxiety), catastrophising, disability, quality of life and health in a population of patients with chronic pain.

Method: The study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 patients with chronic whiplash-associated disorders and 236 patients with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological- and health-related variables.

Results: In the multivariate context, depression, anxiety, catastrophising and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables - duration of pain, pain intensity and spreading of pain - formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophising and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life and health.

Conclusion: There is a complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.