Pain and Self-Efficacy Among Patients With Systemic Sclerosis

Abstract

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 1903 adults, with a trajectory subsample of 427 who completed three-month assessments across three-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 selfefficacy 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 selfefficacy 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 PAIN IN SYSTEMIC SCLEROSIS with systemic sclerosis. Additionally, 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.

Process of Maintaining Self in Individuals Living With Systemic Sclerosis: A Grounded Theory Study of American Women

“…Pain, fatigue, and complications related to activity are important to managing systemic sclerosis. 48,49 Staying physically active is important to self-managing rheumatic diseases. 50 Nursing interventions directed at maintaining self can include asking patients to provide a list of physical activities that they enjoy along with which ones are most important to them.…”