The role of self-efficacy, pain catastrophizing, and fear of movement on chronic pain adjustment of rheumatoid arthritis patients

 Aims and background: People respond to chronic pain in various ways and pain adjustment is not the same in different individuals. The aim of the current study is the assessment of the level of chronic pain adjustment in rheumatoid arthritis (RA) patients based on the quality of life, physical disability, and the level of their depression. In addition, the role of three variables, pain catastrophizing, fear of movement, and self-efficacy in a relationship with chronic pain adjustment was assessed. Materials and methods: In this cross-sectional study, 123 RA patients who had chronic pain and were over 18 years old were included. Patients were attending the outpatient rheumatology clinic, Shariati Hospital from May 2017 until May 2018. Patients were assessed by the Short-Form Health Survey (SF-36), Pain Self-Efficacy Questionnaire (PSEQ), Physical Disability Questionnaire (PDQ), Depression, Anxiety and Stress Scales (DASS), Tampa Scale for Kinesiophobia (TSK), and Pain Catastrophizing Scale (PCS). Data were analyzed by Pearson correlation and multiple linear regression methods. Findings: Our results showed that there is an association between self-efficacy, fear of movement, and pain catastrophizing with chronic pain adjustment (P<0.01). According to the multiple linear regression analysis, fear of movement and pain catastrophizing are in a correlation with the physical disability. The finding demonstrated that self-efficacy and pain catastrophizing variables influence the patient’s depression. In addition, pain catastrophizing, fear of movement, and self-efficacy influenced the patient’s physical and mental quality of life. Conclusion: The relationship between pain and physical disability and other aspects of chronic pain adjustment are adjusted by pain beleifs and pain coping strategies.