Abstract
Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals. Measures of pain intensity and interference, physical and psychological functioning, coping responses, self-efficacy, and satisfaction with social support were administered to a sample of 324 Portuguese patients with chronic musculoskeletal pain. Univariate and multivariate analyses were computed. Findings were interpreted with respect to those from similar studies using English-speaking individuals. Coping responses and perceived social support were significantly associated with pain interference and both physical and psychological functioning; self-efficacy beliefs were significantly associated with all criterion variables. All coping responses, except for task persistence, were positively associated with pain interference and negatively associated with physical and psychological functioning, with the strongest associations found for catastrophizing, praying/hoping, guarding, resting, asking for assistance, and relaxation. The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.
Highlights
Chronic pain is a significant health problem estimated to affect about one out of five adults worldwide [1,2]
It was found that unlike the results often found in English speaking samples, (1) task persistence, as measured by the Chronic Pain Coping Inventory, was not negatively associated with measures of pain and dysfunction, (2) seeking social support was moderately and positively associated to pain interference, (3) praying/hoping was moderately negatively associated with depression, and (4) increasing behavioral activities was negatively associated with depression
Consistent with previous research with patients of other countries and cultures [4,5,7,9,10,13,1518,20,22,40,41,65,66], psychosocial factors were significantly associated with pain intensity, pain interference, and both physical and psychological functioning
Summary
Chronic pain is a significant health problem estimated to affect about one out of five adults worldwide [1,2]. It was found that unlike the results often found in English speaking samples, (1) task persistence, as measured by the Chronic Pain Coping Inventory, was not negatively associated with measures of pain and dysfunction, (2) seeking social support was moderately and positively associated to pain interference, (3) praying/hoping was moderately negatively associated with depression, and (4) increasing behavioral activities was negatively associated with depression These dissimilarities suggest that not all research performed with English speaking samples generalize to other cultures. If the findings from previous studies performed with English speaking samples were to replicate, we would hypothesize that (1) self-efficacy beliefs and perceived social support would be significantly and negatively associated with pain intensity and pain interference, and positively associated with general physical and psychological functioning [5,10,12,13,14,15,16,46,47,48]. We would hypothesize that (2) both adaptive and maladaptive coping responses would show weak to moderate associations with pain, pain interference, and physical and psychological functioning, with the coping responses classified as maladaptive tending to show stronger associations than measures of adaptive responses with measures of dysfunction [5,7,16,18,20,21,2325]
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