ArticlesSelf-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health careDenison, Eva*,1; Åsenlöf, P.; Lindberg, P.Author Information Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala Se-751 83, Sweden *Corresponding author. Tel.: +46–702–595–846; fax: +46–184–713–490. E-mail: [email protected] 1http://www.pubcare.uu.se/care/index.htm; http://www.uu.se Submitted December 1, 2003; revised June 17, 2004; accepted July 6, 2004. Pain: October 2004 - Volume 111 - Issue 3 - p 245-252 doi: 10.1016/j.pain.2004.07.001 Buy Metrics Abstract This study examined the relations between disability, as measured by the Pain Disability Index (PDI) and self-efficacy, fear avoidance variables (kinesiophobia and catastrophizing), and pain intensity, using a prospective design. Two primary health care samples (n1=210; n2=161) of patients with subacute, chronic or recurring musculoskeletal pain completed sets of questionnaires at the beginning of a physiotherapy treatment period. Multiple hierarchial regression analyses showed that self-efficacy explained a considerably larger proportion of the variance in disability scores than the fear avoidance variables in the first sample. This finding was replicated in the second sample. Pain intensity explained a small, but significant proportion of the variance in disability scores in one sample only. Gender, age, and pain duration were not related to disability. These findings suggest that self-efficacy beliefs are more important determinants of disability than fear avoidance beliefs in primary health care patients with musculoskeletal pain. The findings also suggest that pain-related beliefs, such as self-efficacy and fear avoidance, in turn, are more important determinants of disability than pain intensity and pain duration in these patients. © 2004 Lippincott Williams & Wilkins, Inc.