Self-Efficacy and Chronic Pain Outcomes: A Meta-Analytic Review

A meta-analysis was performed to evaluate overall strengths of relation between self-efficacy (SE) and functioning (pain severity, functional impairment, affective distress) in chronic pain samples, as well as potential moderating effects of sociodemographic characteristics and methodologic factors on these associations. In sum, 86 samples (N = 15,616) fulfilled selection criteria for analysis. SE had negative overall correlations with impairment, affective distress, and pain severity although considerable heterogeneity was observed for all effect sizes. Age, pain duration, SE scale content (SE for functioning despite pain vs SE for pain control vs SE for managing other symptoms such as emotional distress) and type of impairment measure (self-report vs task performance) had significant moderating effects on SE-impairment associations. SE-affective distress relations were moderated by employment status and SE scale content. Finally, moderator analyses of studies having longitudinal designs indicated associations between baseline SE, and each outcome at follow-up remained significant in prospective studies that had statistically controlled for effects of baseline responses on that outcome. Hence, SE is a robust correlate of key outcomes related to chronic pain and a potentially important risk/protective factor that has implications for subsequent functioning in affected groups. Perspective: Meta-analysis indicated that SE has significant overall associations with impairment, affective distress, and pain severity within chronic pain samples and identified several factors that contribute to variability in effect sizes. Findings highlighted SE as a robust correlate and potentially important risk/protective factor for subsequent adjustment in affected groups. (C) 2014 by the American Pain Society