The mediation of disability by self efficacy in different samples of chronic pain patients

Purpose : A path analytic model conceptualizing self efficacy as a mediator of disability was tested. This model could help explain the circumstances under which disability develops more in some chronic pain patients than in others. Method: Questionnaires from 479 chronic pain patients were collected prior to an initial consultative visit with a pain specialist at three pain clini cs. These patients represented three separate samples. One sample from a te rtiary care hospital (n = 226), one from a community-based clinic (n = 137) and a third sample from combined settings, but excluding patients with a h istory of depression prior to the onset of their pain (n = 116). Hypothesiz ed and alternative models were tested to identify the model best fitting th ese data. Results : Regression analysis supported self efficacy as a mediator of the relationship between pain intensity and disability (p <0.001) in all three groups. This model was best supported in the group with no prior depression (accounting for 47% of the explained variance in disability). The 'no-prio r depression' group was different than the other samples in that depression did not contribute to disability in this sample where prior depression was not controlled for. Conclusion : Self efficacy in an important variable contributing to the dis ability of chronic pain patients. Therefore, evaluating and bolstering the patient's belief in their own abilities may be an important component of th erapy.