Academic Scientific JournalsExamining pain severity in women with rheumatoid arthritis: the impact of pain self-efficacy and perceived partner’s emotional support
Keywords:
pain severity, rheumatoid arthritis, pain self-efficacy, partner’s emotional supportAbstract
Background
Empirical data suggest that psychosocial factors, such as pain self-efficacy (PSE) and emotional support from a partner, may alleviate the suffering caused by rheumatoid arthritis (RA) pain. However, the data are ambiguous and warrant a more comprehensive investigation into the effect of these factors on the severity of RA pain. The objective of the present study was to assess the significance of PSE and emotional support from a partner in relation to pain severity among women with RA.
Participants and procedure
The study included a sample of 196 women diagnosed with RA with the mean age of 41.54. The study employed the following measures: Rheumatoid Arthritis Pain Scale, Pain Self-efficacy Questionnaire, and Communication Based Emotional Support Scale.
Results
The analysis revealed that higher PSE emerged as the strongest predictor for lower pain severity across all components of RA pain. However, the impact of the partner’s emotional support on pain severity was not as evident and varied depending on the specific pain component. Furthermore, the use of pain medications significantly predicted three out of four pain components. Mediation analysis revealed that perceived emotional support from a partner directly affected women’s RA pain intensity, as well as indirectly through the PSE as a mediator. Moderated mediation analysis demonstrated that the association between PSE and pain severity weakened as the duration of RA increased.
Conclusions
Enhancing women’s PSE and providing appropriate training for their partners to offer effective emotional support may play a crucial role in the treatment of RA.
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References
Ahlstrand, I., Vaz, S., Falkmer, T., Thyberg, I., & Björk, M. (2017). Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis. Clinical Rehabilitation, 31, 824–834. https://doi.org/ 10.1177/0269215516646166.
Ahmed, S. A., Shantharam, G., Eltorai, A. E., Hartnett, D. A., Goodman, A., & Daniels, A. H. (2019). The effect of psychosocial measures of resilience and self-efficacy in patients with neck and lower back pain. Spine Journal, 19, 232–237. https://doi.org/10.1016/j.spinee.2018.06.007.
Akbari, F., Dehghani, M., Khatibi, A., & Vervoort, T. (2016). Incorporating family function into chronic pain disability: The role of catastrophizing. Pain Research and Management, 2016, 6838596. https://doi.org/10.1155/2016/6838596.
Anderson, D. L. (2001). Development of an instrument to measure pain in rheumatoid arthritis: Rheumatoid Arthritis Pain Scale (RAPS). Arthritis Care & Research, 45, 317–323. https://doi.org/10.1002/1529-0131(200108)45:43.0.CO;2-X.
Arthritis Foundation (n/a). Rheumatoid arthritis: Causes, symptoms, treatments and more. Retrieved from https://www.arthritis.org/diseases/rheumatoid-arthritis.
Bergström, M., Larsson Ranada, Å., Sverker, A., Thyberg, I., & Björk, M. (2023). A dyadic exploration of support in everyday life of persons with RA and their significant others. Scandinavian Journal of Occupational Therapy, 30, 616–627. https://doi.org/10.1080/11038128.2021.2007997.
Bouhouche, L., Rostom, S., Idrissi, Z. M., Bahiri, R., & Hajjaj-Hassouni, N. (2017). Perceptions in rheumatoid arthritis: Comparative study between patients and their close families. Journal of Clinical Rheumatology, 23, 262–266. https://doi. org/10.1097/RHU.0000000000000478.
Briggs, A. M., Fary, R. E., Slater, H., Ranelli, S., & Chan, M. (2013). Physiotherapy co-management of rheumatoid arthritis: Identification of red flags, significance to clinical practice and management pathways. Manual Therapy, 18, 583–587. https://doi.org/10.1016/j.math.2013.01.006.
Christensen, A. W., Rifbjerg-Madsen, S., Christensen, R., Dreyer, L., Tillingsøe, H., Seven, S., Boesen, M., Ellegaard, K., Bliddal, H., DanneskioldSamsøe, B., & Amris, K. (2016). Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: Cross-sectional data from the FRAME study. Scandinavian Journal of Rheumatology, 45, 461–469. https://doi.org/10.3109/03009742.2016.1139174.
Cohen, J. E. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Coty, M. B., & Wallston, K. A. (2010). Problematic social support, family functioning, and subjective well-being in women with rheumatoid arthritis. Women & Health, 50, 53–70. https://doi.org/10.1080/03630241003601079.
Druce, K. L., Cordingley, L., Short, V., Moore, S., Hellman, B., James, B., Lunt, M., Kyle, S. D., Dixon, W. G., & McBeth, J. (2018). Quality of life, sleep and rheumatoid arthritis (QUASAR): a protocol for a prospective UK mHealth study to investigate the relationship between sleep and quality of life in adults with RA. BMJ Open, 8, e018752. https://doi.org/10.1136/bmjopen-2017-018752.
Englbrecht, M., Tarner, I. H., van der Heijde, D. M., Manger, B., Bombardier, C., & Mueller-Ladner, U. (2012). Measuring pain and efficacy of pain treatment in inflammatory arthritis: a systematic literature review. The Journal of Rheumatology Supplement, 90, 3–10. https://doi.org/10.3899/ jrheum.120335.
Fallatah, F., & Edge, D. S. (2015). Social support needs of families: The context of rheumatoid arthritis. Applied Nursing Research, 28, 180–185. https://doi.org/10.1016/j.apnr.2014.10.004.
Galloway, J., Capron, J. P., De Leonardis, F., Fakhouri, W., Rose, A., Kouris, I., & Burke, T. (2020). The impact of disease severity and duration on cost, early retirement and ability to work in rheumatoid arthritis in Europe: an economic modelling study. Rheumatology Advances in Practice, 4, rkaa041. https://doi.org/10.1093/rap/rkaa041.
Gligorov, N. (2018). Telling the truth about pain: Informed consent and the role of expectation in pain intensity. AJOB Neuroscience, 9, 173–182. https://doi.org/10.1080/21507740.2018.1496163.
Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach (2nd ed.). The Guilford Press.
Hashimoto, A., Sonohata, M., & Mawatari, M. (2020). The use of oral analgesics and pain self-efficacy are independent predictors of the quality of life of individuals with rheumatoid arthritis. Pain Research and Management, 2020, 7409396. https://doi.org/10.1155/2020/7409396.
Holtzman, S., Newth, S., & Delongis, A. (2004). The role of social support in coping with daily pain among patients with rheumatoid arthritis. Journal of Health Psychology, 9, 677–695. https://doi. org/10.1177/1359105304045381.
Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. The Electronic Journal of Business Research Methods, 6, 53–60.
Karlsson, B., Berglin, E., & Wallberg-Jonsson, S. (2006). Life satisfaction in early rheumatoid arthritis: a prospective study. Scandinavian Journal of Occupational Therapy, 13, 193–199. https://doi.org/10.1080/11038120500462337.
Khan, C. M., Iida, M., Stephens, M. A. P., Fekete, E. M., Druley, J. A., & Greene, K. A. (2009). Spousal support following knee surgery: Roles of self-efficacy and perceived emotional responsiveness. Rehabilitation Psychology, 54, 28–32. https://doi.org/10.1037/a0014753.
Kostova, Z., Caiata-Zufferey, M., & Schulz, P. J. (2014). The impact of social support on the acceptance process among rheumatoid arthritis patients: a qualitative study. Psychology & Health, 29, 1283– 1302. https://doi.org/10.1080/08870446.2014.925895.
Liu, L., Xu, N., & Wang, L. (2017). Moderating role of self-efficacy on the associations of social support with depressive and anxiety symptoms in Chinese patients with rheumatoid arthritis. Neuropsychiatric Disease and Treatment, 13, 2141–2150. https://doi.org/10.2147/NDT.S137233.
Lopez-Martinez, A. E., Esteve-Zarazaga, R., & Ramírez-Maestre, C. (2008). Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients. The Journal of Pain, 9, 373–379. https:// doi.org/10.1016/j.jpain.2007.12.002.
Martinec, R., Pinjatela, R., & Balen, D. (2019). Quality of life in patients with rheumatoid arthritis – a preliminary study. Acta Clinica Croatica, 58, 157–166. https://doi.org/10.20471/acc.2019.58.01.20.
Martinez-Calderon, J., Meeus, M., Struyf, F., & Luque-Suarez, A. (2020). The role of self-efficacy in pain intensity, function, psychological factors, health behaviors, and quality of life in people with rheumatoid arthritis: a systematic review. Physiotherapy Theory and Practice, 36, 21–37. https://doi.org/10.1080/09593985.2018.1482512.
Martinez-Calderon, J., Zamora-Campos, C., Navarro-Ledesma, S., & Luque-Suarez, A. (2018). The role of self-efficacy on the prognosis of chronic musculoskeletal pain: a systematic review. The Journal of Pain, 19, 10–34. https://doi.org/10.1016/j. jpain.2017.08.008.
Miles, C. L., Pincus, T., Carnes, D., Taylor, S. J., & Underwood, M. (2011). Measuring pain self-efficacy. The Clinical Journal of Pain, 27, 461–470. https:// doi.org/10.1097/AJP.0b013e318208c8a2.
Mittinty, M. M., Vanlint, S., Stocks, N., Mittinty, M. N., & Moseley, G. L. (2018). Exploring effect of pain education on chronic pain patients’ expectation of recovery and pain intensity. Scandinavian Journal of Pain, 18, 211–219. https://doi.org/10.1515/sjpain-2018-0023.
Moyano, S., Scolnik, M., Vergara, F., García, M. V., Sabelli, M. R., Rosa, J. E., Catoggio, L. J., & Soriano, E. R. (2019). Evaluation of learned helplessness, perceived self-efficacy, and functional capacity in patients with fibromyalgia and rheumatoid arthritis. Journal of Clinical Rheumatology, 25, 65– 68. https://doi.org/10.1097/rhu.0000000000000769.
Nash, V. R., Ponto, J., Townsend, C., Nelson, P., & Bretz, M. N. (2013). Cognitive behavioral therapy, self-efficacy, and depression in persons with chronic pain. Pain Management Nursing, 14, e236– e243. https://doi.org/10.1016/j.pmn.2012.02.006.
Nicholas, M. K. (2007). The pain self‐efficacy questionnaire: Taking pain into account. European Journal of Pain, 11, 153–163. https://doi.org/10.1016/j. ejpain.2005.12.008.
Pow, J., Stephenson, E., Hagedoorn, M., & DeLongis, A. (2018). Spousal support for patients with rheumatoid arthritis: Getting the wrong kind is a pain. Frontiers in Psychology, 9, 1760. https://doi. org/10.3389/fpsyg.2018.01760.
Rezaei, F., Doost, H. T. N., Molavi, H., Abedi, M. R., & Karimifar, M. (2014). Depression and pain in patients with rheumatoid arthritis: Mediating role of disease perception. The Egyptian Rheumatologist, 36, 57–64. https://doi.org/10.1016/j.ejr.2013.12.007.
Rice, D., Mehta, S., Shapiro, A., Pope, J., Harth, M., Morley-Forster, P., Sequeira, K., & Teasell, R. (2016). Psychological distress in out-patients assessed for chronic pain compared to those with rheumatoid arthritis. Pain Research and Management, 2016, 7071907. https://doi.org/10.1155/2016/7071907.
Rolbiecki, A., Subramanian, R., Crenshaw, B., Albright, D. L., Perreault, M., & Mehr, D. (2017). A qualitative exploration of resilience among patients living with chronic pain. Traumatology, 23, 89–94. https://doi.org/10.1037/trm0000095.
Ruben, M. A., Jodoin, A. N., Hall, J. A., & Blanch-Hartigan, D. (2017). The impact of acute pain self-efficacy on pain intensity and the accurate recall of pain. Health Psychology Report, 6, 136–145. https:// doi.org/10.5114/hpr.2018.72068.
Sturgeon, J. A., & Zautra, A. (2010). Resilience: a new paradigm for adaptation to chronic pain. Current Pain and Headaches Reports, 14, 105–112. https://doi.org/10.1007/s11916-010-0095-9.
Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Method, 3, 4–70. https://doi.org/10.1177/109442810031002.
van der Maas, L. C., de Vet, H. C., Köke, A., Bosscher, R. J., & Peters, M. L. (2012). Psychometric properties of the Pain Self-Efficacy Questionnaire (PSEQ): Validation, prediction, and discrimination quality of the Dutch version. European Journal of Psychological Assessment, 28, 68–75. https://doi. org/10.1027/1015-5759/a000092.
van der Woude, D., & van der Helm-van Mil, A. H. (2018). Update on the epidemiology, risk factors, and disease outcomes of rheumatoid arthritis. Best Practice & Research Clinical Rheumatology, 32, 174–187. https://doi.org/10.1016/j.berh.2018.10.005.
Vendrusculo-Fangel, L. M., Fangel, R., Vieira de Sousa Neto, I., Nobrega, O. T., Dos Reis, F. J. J., Durigan, J. L. Q., & de Cassia Marqueti, R. (2022). Structural equation modelling provides insights to understand the construct of chronic pain in women with rheumatoid arthritis. Modern Rheumatology, 32, 554–564. https://doi.org/10.1093/mr/roab027.
Weber, K. D., & Patterson, B. R. (1996). Construction and validation of a Communication Based Emotional Support Scale. Communication Research Reports, 13, 68–76. https://doi.org/10.1080/ 08824099609362072.
