Cognitive factors are associated with disability and pain, but not fatigue among physiotherapy attendees with persistent pain and fatigue

Thompson, DP ORCID: https://orcid.org/0000-0003-4709-1686, Antcliff, D ORCID: https://orcid.org/0000-0002-9771-8232 and Woby, SR 2020, 'Cognitive factors are associated with disability and pain, but not fatigue among physiotherapy attendees with persistent pain and fatigue' , Physiotherapy, 106 , pp. 94-100.

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Abstract

Objectives Most research exploring the relationship between cognitive factors and pain, disability and fatigue in patients with persistent pain/fatigue has been performed in multi disciplinary environments. It is unclear whether these associations are consistent in other contexts. This study therefore aimed to establish the relationships between these factors in patients with persistent pain/fatigue referred for physiotherapy treatment. Design Cross-sectional observational study assessing the association between cognitive factors (self-efficacy and catastrophizing) and levels of pain, disability, mental fatigue and physical fatigue in patients with persistent pain/fatigue disorders. Data were analysed using regression analyses. Setting Two out-patient physiotherapy departments, Manchester, UK. Participants 166 patients with persistent pain and fatigue disorders chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalopathy). Main outcome measures Disability was assessed using the Fibromyalgia Impact Questionnaire, whilst mental and physical fatigue were assessed with the sub-scales of the Chalder Fatigue Scale. Pain intensity was measured with a Numeric Pain Rating Scale, self-efficacy with the Chronic Pain Self-efficacy Questionnaire and catastrophizing with the Pain Catastrophizing Scale. Results Cognitive factors were significantly associated with pain (self-efficacy beliefs β = −0.30, P < 0.05; catastrophizing β = 0.24, P < 0.05) and disability (self-efficacy beliefs β = −0.62, P < 0.05), but not fatigue. Conclusions Similar associations were observed in patients referred to physiotherapy as to those observed in patients treated in multi disciplinary clinical environments. Self-efficacy beliefs appear to be particularly strong determinants of disability, but exert a lesser influence over pain or fatigue. Targeting self-efficacy may be an effective method to reduce disability in patients with persistent pain and fatigue disorders.

Item Type: Article
Schools: Schools > School of Health and Society
Journal or Publication Title: Physiotherapy
Publisher: Elsevier
ISSN: 0031-9406
Related URLs:
Depositing User: USIR Admin
Date Deposited: 13 Mar 2020 14:21
Last Modified: 13 Mar 2020 14:21
URI: http://usir.salford.ac.uk/id/eprint/56654

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