Summary of the statistical results about the association between psychological factors and pain intensity (longitudinal analysis)
| The role of psychological factors in the perpetuation of pain intensity in people with chronic shoulder pain | |
| The association between fear-avoidance and pain intensity | Baseline fear-avoidance beliefs (physical activity subscale)-pain intensity at 3 months: B (95% CI)=−0.01 (−0.20 to 0.19), P=0.09053 Baseline fear-avoidance beliefs-pain intensity at baseline: r=0.04, P=0.75; at 4–6 months: r=−0.33, P=0.029; at 12 months: r=−0.29, P=0.0855 |
| The association between fear of pain and pain intensity | Baseline fear of pain-pain intensity at 3–5 months: standardised B=0.08, P=0.58436 |
| The association between kinesiophobia and pain intensity | Baseline kinesiophobia-pain intensity at 3–5 months: standardised B=−0.15, P=0.32936 |
| The association between pain catastrophising and pain intensity | Baseline pain catastrophising-pain intensity at 3 months: B (95% CI)=0.11 (−0.11 to 0.32), P=0.21353 Baseline pain catastrophising-pain intensity at 3 months after surgery: standardised B=0.34, SE=0.04, P=0.04 37 Baseline pain catastrophising-pain intensity at 3– 5 months: standardised B=0.53, P=0.001 36 Baseline pain catastrophising-pain intensity at 6 months: mean (95% CI)=−0.62 (−1.03 to −0.20), P=0.001 25 Baseline pain catastrophising-pain intensity at 6 months after surgery: standardised B=0.05, SE=0.03, P=0.7038 Baseline pain catastrophising-pain intensity at baseline: r=0.02, P=0.88; at 4–6 months: r=−0.20, P=0.21; at 12 months: r=−0.06, P=0.7355 |
| The association between self-efficacy and pain intensity | Baseline pain self-efficacy-pain intensity at 6 weeks after intervention: B (95% CI)=0.9 (−0.2 to 1.9), P=0.151 Baseline pain self-efficacy-pain intensity at 6 months: B (95% CI)=−0.36 (−0.50 to −0.22), P<0.001 22 Baseline pain self-efficacy-pain intensity at 12 months: B (95% CI)=6.0 (2.0 to 9.9), P=0.004 54 Baseline pain self-efficacy-pain intensity at baseline: r=−0.10, P=0.45; at 4–6 months: r=0.10, P=0.51; at 12 months: r=−0.20, P=0.2355 Baseline general self-efficacy-pain intensity at baseline: r=0.12, P=0.37; at 4–6 months: r=0.21, P=0.18; at 12 months: r=0.19, P=0.2755 |
| The association between expectations of recovery and pain intensity | Baseline expectations of recovery-pain intensity at 6 weeks after intervention: B (95% CI)=2.3 (−8.0 to 12.6), P=0.6651 Baseline expectations of recovery-pain intensity at 6 months: much improved: B (95% CI)=−5.21 (−1.80 to 8.61), P=0.003; slightly improved: B (95% CI)=−12.43 (−8.20 to −16.67), P<0.001; no changes/worse: B (95% CI)=−0.94 (−8.53 to 6.66), P=0.80922 Baseline expectations of recovery-pain intensity at 6 months (PSS pain subscore): mean (95% CI)=1.99 (0.17 to 3.82), P=0.033 46 Preoperative expectations-pain intensity at 12 months: VAS B=9.91, P=0.005; DASH: B=11.93, P<0.001 20 Association between preoperative expectations and pain intensity at a minimum of 3 years was not reported42 |
| The association between optimism and pain intensity | Baseline optimism (in the model with pain catastrophising)-pain intensity at 3 months: B (95% CI)=−0.01 (−0.20 to 0.19)53 Baseline optimism (in the model with fear-avoidance beliefs)-pain intensity at 3 months: B (95% CI)=−0.04 (−0.22 to 0.15)53 |
| The association between internal and external locus of control and pain intensity | Baseline external locus of control-pain intensity at 6 months: 3–4: mean (95% CI)=−0.79 (−1.60 to 0.02), P=0.06; >4: mean (95% CI)=0.21 (−0.92 to 1.35), P=0.7125 |
| The association between pain acceptance and pain intensity | Baseline pain acceptance-pain intensity at baseline: r=−0.14, P=0.32; at 4–6 months: r=0.14, P=0.40; at 12 months: r=−0.00, P=0.9955 |
| The association between coping and pain intensity | Association between coping and pain intensity at 6 months was not reported25 |
| The association between resilience and pain intensity | Postoperative resilience-pain intensity (ASES): r=0.41–0.44, P<0.004 47 |
| The association between sleep disturbances and pain intensity | Baseline sleep disturbances-pain intensity at 12 months after surgery: coefficient (95% CI)=0.040 (−0.082 to 0.163), P=0.66439 |
| The association between somatisation and pain intensity | Baseline somatisation-pain intensity at 6 months: mean (95% CI)=−0.16 (−1.01 to 0.68), P=0.7125 Baseline somatisation-pain intensity (DASH) at 12 months: coefficient (95% CI)=−3.00 (−10.53 to 4.52), P=0.43; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.12 (−0.62 to 0.37), P=0.6343 Somatisation at 12 months-pain intensity (DASH) at 12 months: coefficient (95% CI)=−14.37 (−21.23 to −7.51), P<0.001; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.37 (−0.82 to −0.83), P=0.1143 |
| The association between emotional distress and pain intensity | Emotional distress-pain intensity at 6 weeks after intervention: B (95% CI)=7.4 (−3.0 to 17.8), P=0.1651 Baseline emotional distress-pain intensity at 12 months: B (95% CI)=10.3 (−1 to 21.6), P=0.073 54 Baseline emotional distress-pain intensity (DASH) at 12 months: coefficient (95% CI)=0.30 (−6.09 to 6.7), P=0.93; pain intensity at 12 months (Likert scale): coefficient (95% CI)=0.31 (−0.12 to 0.74), P=0.1643 Emotional distress at 12 months-pain intensity (DASH) at 12 months: coefficient (95% CI)=−20.63 (−27.25 to −14.00), P<0.001; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.95 (−1.39 to −0.51), P<0.001 43 Baseline emotional distress (ZUNG questionnaire)-pain intensity at 12 months: B=−0.18, P=0.084 Baseline emotional distress (MSPQ)-pain intensity at 12 months: B=−0.10, P=0.65844 Baseline emotional distress-pain intensity at 3 years: GHQ score 0–1: OR (95% IC)=1.0; GHQ score 2–4: OR (95% CI)=0.8 (0.3 to 2.7); GHQ score≥5: OR (95% CI)=2.6 (0.8 to 7.7)56 Changes in emotional distress and changes in pain intensity at 24 months were not reported52 Association between emotional distress and pain intensity was not reported25 |
| The association between depressive symptoms and pain intensity | Baseline depressive symptoms-pain intensity 2 weeks postsurgery: r=0.463; 3 weeks: r=0.261; 6 weeks; r=0.19150 Baseline depressive symptoms-pain intensity at 3 months after surgery: standardised B=0.33, SE=0.06, P=0.04 37 Baseline depressive symptoms-pain intensity at 6 months after surgery: standardised B=0.18, SE=0.05, P=0.1538 Baseline depressive symptoms-pain intensity at baseline (r=0.309, P<0.05); 6 weeks (r=0.376, P<0.01); 6 months after surgery (r=0.508, P<0.01) 41 Baseline depressive symptoms-pain intensity (OSS) at baseline (r=−0.319, P<0.01); 6 weeks (r=−0.490, P<0.01); 6 months after surgery (r=−0.626, P<0.01) 41 Baseline depressive symptoms-pain intensity at 48 months (median): no depression: OR=1; depressive symptoms: OR (95% CI)=1.96 (1.07 to 3.58), P=0.029 23 Baseline depressive symptoms-pain intensity at 12 months after surgery: coefficient (95% CI)=−0.073 (−0.298 to 0.152), P=0.51539 Baseline depressive symptoms-pain intensity at 12 months after surgery: coefficient (95% CI)=−0.016 (−0.276 to 0.244), P=0.89940 Baseline depressive symptoms-pain intensity at baseline: r=0.14, P=0.29; at 4–6 months: r=−0.19, P=0.22; at 12 months: r=−0.11, P=0.9555 Baseline depressive symptoms-pain intensity (DASH) at 12 months: coefficient (95% CI)=−4.68 (−14.72 to −5.36), P=0.36; pain intensity at 12 months (Likert scale): coefficient (95% CI)=0.09 (−0.56 to 0.74), P=0.7843 Depressive symptoms at 12 months-pain intensity (DASH) at 12 months: coefficient (95% CI)=−16.59 (−23.86 to −9.32), P<0.001; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.79 (−1.26 to −0.32), P=0.001 43 Baseline depressive symptoms-pain intensity at a minimum of 24 months: OR (95% CI)=11.2 (2.0 to 61.3), P=0.005 48 Baseline depressive symptoms-pain intensity (ASES) at 24 months: P=0.018 49 Changes in depressive symptoms and changes in pain intensity at 24 months were not reported52 Association between depressive symptoms and pain intensity was not reported25 |
| The association between anxiety and pain intensity | Baseline anxiety-pain intensity 2 weeks postsurgery: r=0.026, P<0.05; 3 weeks: r=0.364; 6 weeks: r=0.30150 Baseline anxiety-pain intensity at 3 months after surgery: standardised B=−0.22, SE=0.04, P=0.2637 Baseline anxiety-pain intensity at 3–5 months: standardised B=0.07, P=0.64636 Baseline anxiety-pain intensity at baseline (r=0.309, P<0.05); 6 weeks (r=0.376, P<0.01); 6 months after surgery (r=0.508, P<0.01) 41 Baseline anxiety-pain intensity (OSS) at baseline (r=−0.319, P<0.01); 6 weeks (r=−0.490, P<0.01); 6 months after surgery (r=−0.626, P<0.01) 41 Baseline anxiety-pain intensity at 12 months after surgery: coefficient (95% CI)=0.115 (−0.053 to 0.283), P=0.17439 Baseline anxiety-pain intensity at 12 months after surgery: coefficient (95% CI)=−0.010 (−0.363 to 0.142), P=0.38240 Baseline anxiety-pain intensity at baseline: r=0.16, P=0.26; at 4–6 months: r=−0.18, P=0.22; at 12 months: r=−0.26, P=0.1355 Baseline anxiety-pain intensity (DASH) at 12 months: coefficient (95% CI)=−6.25 (−13.84 to 1.30), P=0.10; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.27 (−0.75 to 0.21), P=0.2743 Anxiety at 12 months-pain intensity (DASH) at 12 months: coefficient (95% CI)=−11.62 (−19.15 to −4.10), P=0.003; pain intensity at 12 months (Likert scale): coefficient (95% CI)=−0.46 (−0.94 to 0.19), P=0.0643 Changes in anxiety and changes in pain intensity at 24 months were not reported52 Association between anxiety and pain intensity was not reported25 |
*Significant results are shown in bold.
ASES, Arthritis Self-Efficacy Scale; B, beta-coefficient; DASH, the Quick Disability of the Arm, Shoulder and Hand Questionnaire; GHQ, the General Health Questionnaire; MSPQ, Modified Somatic Perceptions Questionnaire; OSS, the Oxford Shoulder Score; PSS, the Penn Shoulder Score; r, Pearson’s coefficient of correlation; VAS, Visual Analogue Scale; ZUNG questionnaire: modified Zung Depression Scale.