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Publications

Journal Article Epublish

PubMed: 42416526 DOI: 10.2147/JPR.S588853

The Concurrent and Temporal Associations Between Pain Self-Efficacy, Sleep Disturbance, and Pain Intensity in Individuals with Chronic Pain: A Cross-Lagged Analysis.

J Pain Res 19:588853

Authors: Raviwon Atisook, Pramote Euasobhon, Suratsawadee Wangnamthip, Sarocha Watatham, Julaporn Pooliam, Caixia Li, Mark P Jensen

Affiliations

  • Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
  • Research Group and Research Network Division, Research Department, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China.
  • Department of Rehabilitation Medicine, University of Washington, Seattle, WA, 98195, USA.

Abstract

PURPOSE

The objective of this study was to replicate and extend prior evidence regarding the concurrent associations among pain self-efficacy, sleep disturbance, and pain intensity in adults with chronic pain, and to evaluate their temporal associations over time.

PATIENTS AND METHODS

This prospective study enrolled 300 Thai chronic pain outpatients from Siriraj Hospital, of whom 50 were excluded due to loss to follow-up, yielding a final sample of 250 participants. Standard questionnaires were administered to assess pain severity, pain self-efficacy, and sleep disturbance at baseline (initial visit) and again at a follow-up assessment conducted about 6 weeks later (range 4-8 weeks). Longitudinal associations were examined using cross-lagged panel models with covariate adjustment, and moderation analyses were conducted using multiple linear regression with interaction terms.

RESULTS

Participants were primarily female with a mean age of 54 years; neuropathic pain was the most common condition. Due to the COVID-19, about half of the participants (52%) did not return to the hospital for follow-up. However, they did return completed follow-up questionnaires via email. The average time between two assessments was 6.25 ± 1.77 weeks. Concurrent associations among pain intensity, sleep disturbance, and pain-related self-efficacy were observed in expected directions (correlations ranging from r's = 0.42 to 0.47). After controlling for age, birth sex, education level, and pain duration, each primary study variable was significantly correlated with its corresponding variable at follow-up (r's = 0.42 to 0.56). The only significant cross-lagged association to emerge was between pain-related self-efficacy at the initial visit and pain intensity at follow-up (β = 0.17, p < 0.01). In unadjusted regression, T1 self-efficacy was negatively associated with T2 pain intensity (β = -0.11, p = 0.08), but the direction reversed and became significant after adjustment (β = 0.18, p < 0.01), indicating a statistical suppression effect.

CONCLUSION

Medium to large concurrent associations were observed in expected directions between measures of pain severity, pain self-efficacy, and sleep disturbance; each of these measures were also stable over time. Only one significant cross-lagged effect emerged, which may reflect statistical suppression rather than a true adverse temporal effect. The temporal associations between these domains require further longitudinal evaluation.

MeSH

Chronic Pain, Pain, Sleep, Self Efficacy