The Relationship between Beliefs about Pain and Functional Ability with Arthritic conditions.

Abstract

Objective: Beliefs about pain are an emerging area of research in the biopsychosocial model of pain. Beliefs about the experience of pain have been shown to influence motivation, compliance, understanding of pain mechanisms and outcomes. The aim of this study was to determine the relationship between beliefs about pain and functional ability for those with arthritic conditions.

Design and Setting: Voluntary, anonymous participation was sought from participants of Arthritis New Zealand’s (ANZ) programmes of exercise classes and education. Demographic data, covariables and validated, reliable instruments were used; the Arthritis Impact Measurement Scale 2nd version – Short Form (AIMS2-SF) was used to measure functional ability; the two scales of organic and psychological beliefs in the Pain Beliefs Questionnaires (PBQ) were used to measure pain beliefs. Intervention: 144 Members of ANZ were surveyed anonymously with the AIMS2-SF and PBQ. There was a 61% response rate. Outcome measure: This study used α of 0.05, and the 1- β of 0.8 to detect significant effect size estimated to be r = 0.25. This significance level was for the linear regression analysis of the relationship between the scores of the AIMS2-SF and the organic and psychological beliefs of the PBQ as well as the ANOVA analysis of categorical variables. Results: The linear regression analysis revealed a significant relationship between the organic beliefs scale of the PBQ and the functional ability of the AIMS2-SF with an r-value of 0.32 and p value of 0.00008. There was no relationship between the psychological beliefs scale of the PBQ and the AIMS2-SF. Better functional ability was influenced significantly by the following: those with less feeling of anger and resentment about pain; those who exercised five times a week; those who always enjoyed their exercise; those who were always confident with their exercise and those who reported their prescription medication to be helpful. Conclusion: Organic pain beliefs, the belief that the pain experience indicates harm or a threat to well-being is associated with poorer functional ability. Psychological pain beliefs, the beliefs about the internal influences and feelings affecting the experience of pain are not associated with functional ability. It is recommended that clinicians ask their patients about pain beliefs and address organic pain beliefs early in their consultations. Patients with arthritic conditions who respond in the affirmative should be encouraged to modify their organic beliefs and a model is developed as a tool to assist clinicians. Future research to improve interventional programme outcomes could clarify the causal links between organic pain beliefs and functional ability as well as validate covariate data significant findings.