Pain and Self-Efficacy Among Patients With Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study.
Robyn K Wojeck, Susan G Silva, Donald E Bailey and 7 others
PMID 34173376WHAT IT FOUND
In adults with systemic sclerosis, pain and confidence managing pain did not change detectably over three years, although at baseline higher confidence was linked to less pain.
Key findings
01At baseline, greater confidence managing pain was associated with less pain interference and less pain intensity after adjusting for patient characteristics.
02Across 36 months, confidence managing pain, pain interference, and pain intensity did not change detectably, and change in confidence did not explain how pain changed over time.
03Finger ulcers, moderate-to-severe small joint contractures, and esophageal gastrointestinal symptoms were associated with higher pain and lower confidence managing pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cohort was a convenience sample of patients who had internet access and could complete online measures, so it may not represent all people with systemic sclerosis. The 36-month analysis included only 427 patients and did not have enough power to detect very small changes over time. Confidence was measured with one item from a longer scale, and the reliability and validity of that single pain item were not tested. The study was observational, so it cannot show that changing confidence causes changes in pain. Patients had a mean time since diagnosis of 9.5 years, so findings may not apply to newly diagnosed patients or those with much longer disease. Significance was not adjusted for multiple testing because the study was exploratory.
Declared interests
The supplied metadata lists NIH extramural and non-U.S. government research support. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that improving confidence in managing pain will reduce pain. This was an observational study, and change in confidence over 36 months did not explain how pain changed over time.