When and why pain-related social support for functional dependence leads to older adults' pain-related disability
AbstractBackground: Pain-related social support has been shown to be directly associated with pain-related disability, depending on whether it promotes functional autonomy or dependence. The temporal relationship between pain-related social support and disability and its behavioral and psychological mediating processes are understudied. Therefore, drawing on the fear-avoidance model of pain (Vlaeyen et al., 1995), the present study aimed at investigating longitudinally (1) the direct effects of pain-related social support for functional autonomy/dependence on pain-related disability, (2) the mediating role of physical functioning, pain-related self-efficacy and fear, and (3) whether pain intensity and pain duration moderate such mediating processes. Methods: 170 older adults (67.6% women; Mage=78.3) participated in a prospective study, with three moments of measurement, with a 6-week lag in-between. Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the 36-SF Health Survey, behavioral tasks from the Senior Fitness Test, the Pain Self-Efficacy Questionnaire and the Tampa Scale for Kinesiophobia. Results: Longitudinal mediation and moderated mediation models were tested. Formal social support for functional dependence (T1) predicted an increase in pain-related disability (T3, B=.89). This effect was fully mediated by physical functioning (T2, B=.49) and by pain-related self-efficacy (T2, B=.52), but mainly at shorter pain duration and low/moderate pain intensity. Discussion: Findings clarify the temporal relationship between social support for functional dependence and pain-related disability, uncovering some of its behavioral and psychological mediating processes. These results could inform the development of future training programs with formal caregivers.
Copyright (c) 2017 S. Bernardes, M. Matos, L. Goubert
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