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Cited by 392Musculoskeletal pain and rehabilitationPediatric Pain Management TechniquesPain Management and Treatment

Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care

Denison, Eva, Åsenlöf, P., Lindberg, P.·2004·Pain
DOI 10.1016/j.pain.2004.07.001
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Abstract

This study examined the relations between disability, as measured by the Pain Disability Index (PDI) and self-efficacy, fear avoidance variables (kinesiophobia and catastrophizing), and pain intensity, using a prospective design. Two primary health care samples (n(1)=210; n(2)=161) of patients with subacute, chronic or recurring musculoskeletal pain completed sets of questionnaires at the beginning of a physiotherapy treatment period. Multiple hierarchial regression analyses showed that self-efficacy explained a considerably larger proportion of the variance in disability scores than the fear avoidance variables in the first sample. This finding was replicated in the second sample. Pain intensity explained a small, but significant proportion of the variance in disability scores in one sample only. Gender, age, and pain duration were not related to disability. These findings suggest that self-efficacy beliefs are more important determinants of disability than fear avoidance beliefs in primary health care patients with musculoskeletal pain. The findings also suggest that pain-related beliefs, such as self-efficacy and fear avoidance, in turn, are more important determinants of disability than pain intensity and pain duration in these patients.

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Crossref · 10.1016/j.pain.2004.07.001

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  • In chronic pain research, perceived self-efficacy modulates pain perception and determines coping behavior and quality of life, independently of and often more strongly than physical variables such as pain intensity or duration.

    “One exception is the area of chronic pain research, where several studies demonstrated that perceived self-efficacy not only modulates pain perception (Bandura et al., 1987), but crucially determines coping behavior and quality of life, independently of and often more strongly than physical variables, such as pain intensity or duration (Arnstein et al., 1999; Denison et al., 2004; Burke et al., 20”

    From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Denison et al., 2004

  • High self-efficacy is suggested to be a more robust determinant of disability than pain intensity or duration.

    “As high self-efficacy is suggested to be a more robust determinant of disability than pain intensity or duration,29”

    From New approaches towards chronic pain: Patient experiences of a solution-focused pain management programme (2014) · cites this paper as [29]

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Authors
Denison, E., Åsenlöf, P., & Lindberg, P.
Affiliations
Uppsala University (SE)
Corresponding author
Denison, Eva
ORCID
Åsenlöf, P.
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-10
Volume
111
Issue
3
Pages
245-252
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2004.07.001
OpenAlex
W2072413892
Cited by
392
References
45
Citations by year
2026: 6 · 2025: 7 · 2024: 15 · 2023: 6 · 2022: 11 · 2021: 11 · 2020: 19 · 2019: 18 · 2018: 25 · 2017: 23 · 2016: 30 · 2015: 23 · 2014: 19 · 2013: 23 · 2012: 15
FWCI
7.07
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
Funders
Vårdalstiftelsen
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
self-efficacy, fear avoidance, pain intensity, disability, musculoskeletal pain, chronic pain, subacute pain, kinesiophobia, pain catastrophizing, Pain Disability Index, pain beliefs, physiotherapy, primary care
MeSH terms
Adult, Aged, Avoidance Learning, Chronic Disease, Disability Evaluation, Fear, Female, Humans, Male, Middle Aged, Musculoskeletal Diseases, Pain, Pain Measurement, Predictive Value of Tests, Primary Health Care, Regression Analysis, Self Efficacy

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