The mediating role of self-efficacy expectations and fear of movement and (re)injury beliefs in two samples of acute pain

Abstract

Purpose. The overall aim of this study was to estimate the possible mediating role of self-efficacy, catastrophic thinking and fear of movement and (re)injury between pain intensity and pain-related disability in two samples of acute pain patients, i.e. patients with musculoskeletal injuries and patients with whiplash injury.

Method. A cross sectional design with data-collection after an acute injury was used. Subjects were recruited at an emergency department. Sixty-four patients with acute whiplash associated disorders (WAD) and 74 patients with musculoskeletal injury completed the questionnaires.

Results. Self-efficacy was found to be a mediator between pain intensity and pain-related disability in the WAD group, whereas fear of movement and (re)injury appeared as mediator in the musculoskeletal-injury group. The strength of association between variables was weaker in the musculoskeletal-injury group compared to the WAD group.

Conclusions. It is important to assess fear of movement beliefs in patients with musculoskeletal injuries. Similarly, patients with acute WAD expressing low self-efficacy beliefs should be identified. An early detection of these beliefs may improve management at the acute phase and possibly reduce risks for slow improvements.

Keywords:

• Self efficacy
• fear of movement
• disability
• injury
• pain
• mediator

Acknowledgements

The authors thank the physiotherapist colleagues at the Akademiska hospital, Uppsala, Sweden, who assisted with the data collection. This research was funded by the Faculty of Medicine, Uppsala University, Sweden. All authors have contributed to the article by collecting and analysing the data as well as writing the article.