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Publication
Pain-related beliefs, coping, and function: An observational study on the moderating influence of country of origin
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Advisor(s)
Abstract(s)
Chronic pain is a multidimensional experience and pain treatments targeting psychosocial
factors reduce pain and improve function. These treatments often overlook the sociocultural factors that
influence pain and the psychological factors associated with function in people with chronic pain.
Although preliminary findings suggest that cultural background may influence pain and function via
their effects on beliefs and coping, no previous study has directly tested if the country of origin moderates
the associations between these psychological factors and pain and function. This study sought to
address this knowledge gap. Five hundred sixty-one adults with chronic pain, born and living in the USA
(n = 273) or Portugal (n = 288), completed measures of pain, function, pain-related beliefs, and coping.
Between-country similarities were found in the endorsement of beliefs related to disability, pain control,
and emotion, and in asking for assistance, task persistence, and coping self-statement responses.
Portuguese participants reported greater endorsement of harm, medication, solicitude, and medical cure
beliefs, more frequent use of relaxation and support seeking, and less frequent use of guarding, resting,
and exercising/stretching. In both countries, disability and harm beliefs and guarding responses were
associated with worse outcomes; pain control and task persistence were associated with better outcomes.
Six country-related small effect-size moderation effects emerged, such that task persistence and
guarding are stronger predictors of pain and function in adults from the USA, but pain control, disability,
emotion, and medication beliefs are more important in adults from Portugal. Some modifications may be
needed when adapting multidisciplinary treatments from one country to another.
Perspective: This article examines the similarities and differences in beliefs and coping endorsed
by adults with chronic pain from 2 countries, and the potential moderation effects of country on the
associations between these variables and pain and function. The findings suggest that some modifications
may be needed when culturally customizing psychological pain treatments.
Description
Keywords
Chronic pain Cross-cultural Pain-related beliefs Pain coping Moderation
Citation
Ferreira-Valente, A., Sharma, S., Chan, J., Bernardes, S. F., Pais-Ribeiro, J., & Jensen, M. P. (2023). Pain-Related Beliefs, Coping, and Function: An Observational Study on the Moderating Influence of Country of Origin. The Journal of Pain, 24(9), 1645–1663. https://doi.org/10.1016/j.jpain.2023.04.012
Publisher
Churchill Livingstone