Journal
NURSING RESEARCH
Volume 70, Issue 5, Pages 334-343Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NNR.0000000000000528
Keywords
pain; scleroderma; self-efficacy; systemic sclerosis
Categories
Funding
- National Institute of Nursing Research of the National Institutes of Health [F31NR019007]
- Jonas Nurse Scholars Initiative
- Canadian Institutes of Health Research
- Canadian Initiative for Outcomes in Rheumatology Care
- Arthritis Society
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- McGill University, Montreal, Canada
- Scleroderma Society of Ontario
- Scleroderma Canada
- Sclerodermie Quebec
- Scleroderma Manitoba
- Scleroderma Atlantic
- Scleroderma Association of British Columbia
- Scleroderma Association of Saskatchewan
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This study found associations between self-efficacy and pain in patients with systemic sclerosis, but self-efficacy did not mediate changes in pain trajectories. Factors such as age, gender, finger ulcers, small joint contractures, and esophageal gastrointestinal symptoms were related to pain outcomes.
Background Pain is one of the most common symptoms affecting patients with systemic sclerosis; however, little is known about the relationship between self-efficacy and pain and changes in pain over time. Objectives The purpose of this study was to describe the relationships between self-efficacy and pain in patients with systemic sclerosis, as well as determine whether changes in self-efficacy mediate changes in pain. Methods A prospective longitudinal study was conducted using data from the Scleroderma Patient-Centered Intervention Network Cohort. The baseline sample included 1,903 adults, with a trajectory subsample of 427 who completed 3-month assessments across 3 years. Hierarchical (sequential) forward multivariable regression, covarying for participant characteristics, was conducted to determine the association between self-efficacy and patient characteristics on pain outcomes. Trajectory models, covarying for participant characteristics, were used to examine changes in self-efficacy and pain outcomes across time and whether self-efficacy mediated the pain trajectories. Results Mean time since diagnosis was 9.5 years, with 39.2% diagnosed with diffuse cutaneous systemic sclerosis. Greater self-efficacy was associated with less pain interference and intensity. Increasing age, female gender, finger ulcers, and small joint contractures were related to greater pain interference and intensity. Esophageal gastrointestinal symptoms were associated with more pain interference. Self-efficacy and pain trajectories remained stable across time, and self-efficacy did not mediate the pain trajectories. Discussion This study identified self-efficacy, age, gender, finger ulcers, small joint contractures, and esophageal gastrointestinal symptoms as important correlates associated with pain in patients with systemic sclerosis. In addition, this study found that self-efficacy and pain outcomes remained stable over time, providing important insights into the longitudinal pain experiences of patients with systemic sclerosis.
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