The role of self-efficacy and catastrophizing in explaining improvements in disability, pain and fatigue among patients with chronic widespread pain treated with physiotherapy : an exploratory analysis

Thompson, DP; Antcliff, D; Woby, SR

Abstract

Most research exploring the relationship between cognitive factors (catastrophizing and self-efficacy beliefs) and levels of pain, disability and fatigue in patients with chronic widespread pain has been performed in multidisciplinary environments. It is less clear whether these associations are valid in other clinical environments. This study therefore aimed to establish whether changes in cognitive factors were related to changes in pain, disability and fatigue among patients treated in a physiotherapy-led symptom management programme. A longitudinal pre-post treatment study. Regression analyses were performed with change in pain, disability, physical and mental fatigue as the dependent measures. Demographics, change in pain and fatigue (when not dependent variables) and cognitive factors were entered as independent variables. β values were calculated for the final model. Two out-patient physiotherapy departments in Manchester, UK. Fifty patients with persistent widespread pain. A physiotherapist-led symptom management programme. Disability (Fibromyalgia Impact Questionnaire), Pain (Numeric Pain Rating Scale and Fatigue (Chalder Fatigue Scale) RESULTS: Significant changes in disability, fatigue and cognitive factors were observed after treatment. Changes in self-efficacy beliefs (β=-0.38, P<0.05) and catastrophizing (β=0.41, P<0.05) were significantly related to reductions in disability. There was no significant relationship between change in the cognitive variables and change in pain or fatigue. Self-efficacy beliefs and catastrophizing were important determinants of change in disability, but not pain or fatigue among patients with chronic widespread pain attending physiotherapy. Cognitively-informed physiotherapy appeared to be effective in reducing disability and fatigue and modifying cognitive factors. Such interventions may offer an effective treatment option for patients with chronic widespread pain and future randomised controlled trials are required to fully assess this. [Abstract copyright: Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.]

Citation

Thompson, D., Antcliff, D., & Woby, S. (2021). The role of self-efficacy and catastrophizing in explaining improvements in disability, pain and fatigue among patients with chronic widespread pain treated with physiotherapy : an exploratory analysis. Physiotherapy, https://doi.org/10.1016/j.physio.2021.03.009

• Journal Article Type: Article
• Online Publication Date: Mar 24, 2021
• Publication Date: Mar 24, 2021
• Deposit Date: Oct 12, 2021
• Journal: Physiotherapy
• Electronic ISSN: 1873-1465
• Publisher: De Gruyter
• DOI: https://doi.org/10.1016/j.physio.2021.03.009
• Publisher URL: https://doi.org/10.1016/j.physio.2021.03.009
• Related Public URLs: https://www.journals.elsevier.com/physiotherapy/
• Additional Information: Additional Information : ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1873-1465 **Article IDs: pubmed: 34579952; pii: S0031-9406(21)00028-6 **History: submitted 17-07-2020