Abstract
Chronic pain, chronic fatigue, and depressive mood are prevalent conditions in people
with spinal cord injury (SCI). The objective of this research was to investigate the
relationship between these conditions in adults with SCI. Multivariate analysis of
variance, contingency analyses, and hierarchical regression were used to determine
the nature of the relationship, as well as the contribution to this relationship of
self-efficacy, a potential mediator variable. Seventy participants with SCI living
in the community completed an assessment regimen of demographic and psychometric measures,
including validated measures of pain, fatigue, depressive mood, and self-efficacy.
Results indicated that participants with high levels of chronic pain had clinically
elevated depressive mood, confusion, fatigue, anxiety and anger, low vigor, and poor
self-efficacy. Participants with high chronic pain had 8 times the odds of having
depressive mood and 9 times the odds of having chronic fatigue. Regression analyses
revealed that chronic pain contributed significantly to elevated depressive mood and
that self-efficacy mediated (cushioned) the impact of chronic pain on mood. Furthermore,
both chronic pain and depressive mood were shown to contribute independently to chronic
fatigue. Implications of these results for managing chronic pain in adults with SCI
are discussed.
Perspective
The relationship between pain, negative mood, fatigue, and self-efficacy in adults
with SCI was explored. Results support a model that proposes that chronic pain lowers
mood, which is mediated (lessened) by self-efficacy, whereas pain and mood independently
increase chronic fatigue. Results provide direction for treating chronic pain in SCI.
Key words
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Article info
Publication history
Published online: May 28, 2013
Accepted:
March 7,
2013
Received in revised form:
March 1,
2013
Received:
January 7,
2013
Footnotes
The study was supported by the New South Wales Premier SCI Grant (RIPG4), and by a grant from the Australian Research Council (LP0560590).
The authors have no conflicts of interest financial or otherwise, related to this study.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
