Associations between Self-Efficacy and Pain Outcomes:a Meta-Analytic Review and an Experimental Study

Associations between Self-Efficacy and Pain Outcomes:a Meta-Analytic Review and an Experimental Study

作者:师大云端图书馆 时间:2017-06-05 分类:参考文献 喜欢:2201
师大云端图书馆

【摘要】Duringthepastthreedecades,self-efficacy(SE)hasemergedasawidelyexaminedpsychologicalinfluencesonchronicpainandrelatedfunctionaloutcomes.Bandura[13-15]definedSEasconfidencethatonecansuccessfullyexecuteacourseofactiontoproduceadesiredoutcomeinagivensituationandcontendedSEdetermineshowmucheffortandpersistencepeopleexhibitinthefaceofobstaclesoraversiveexperiences.AlthoughnumerousstudieshavelinkedSEwithmoreadaptivefunctioninginchronicpainsamples,somestudieshavereportednulleffectsofSEonfunctioning.GiveninconsistenciesintheresearchonSEandadjustmentinchronicpainsamples,themainpurposeofthisresearchwastoperformameta-analysisto(1)evaluateoverallstrengthsofrelationbetweenSEandkeyoutcomesofchronicpain(i.e.,painseverity,functionalimpairment,affectivedistress)and(2)toidentifypotentialmoderatingeffectsofspecificsamplecharacteristicsandmethodologicalfactorsontheseassociations.AsystematicsearchoftheliteratureonSEandchronicpainresultedintheinitialconsiderationof1688studies.Screeningofthesestudiesforappropriatepapersresultedintheidentificationof83studiescomprising86samples(N=15,616)thatfulfilledselectioncriteriaforinclusioninthemeta-analysis.DataanalysesindicatedSEhadsignificantnegativeoverallcorrelationswithimpairment(r=-0.49,p<0.001,95%CI:-0.55to-0.43),affectivedistress(r=-0.43,p<0.001,95%CI-0.47to-0.39),andpainseverity(r=-0.39,p<0.001,95%CI:-0.44to-0.34).However,highlevelsofheterogeneitywereevidentinanalysesofoverallrelationsbetweenSEandeachoutcome.Moderatoranalysesindicatedage,painduration,SEscalecontent(i.e.,SEforfunctioningdespitepainversusSEforpaincontrolversusSEformanagingothersymptomssuchasemotionaldistress)andtypeofimpairmentmeasure(self-reportversusperformance)hadsignificantmoderatingeffectsonSE-impairmentassociations.SE-affectivedistressrelationswerealsomoderatedbyemploymentstatusandSEscalecontent.However,moderatoranalysesfailedtoidentifysampleormethodologicalfactorsthathelpedtoexplainvariabilityineffectsizesreflectingSE-painseverityrelations.Notably,moderatoranalysesofstudieshavinglongitudinaldesignsindicatedoverallstrengthsofrelationbetweenSEandeachoutcomeatfollow-upremainedsignificantwithinsubsetsofstudiesthathadstatisticallycontrolledforeffectsofbaselineresponsesonthatoutcome.Assuch,analysesindicatedSEisbotharobustcorrelateofkeyoutcomesrelatedtochronicpainandapotentiallyimportantrisk/protectivefactorthathasimplicationsforsubsequentfunctioninginaffectedgroups.Finally,resultsoftrimandfillanalysesconductedtoadjustforeffectsofpublicationbiasindicatedthatadjustedeffectsizesofSEandeachofthethreeoutcomeswereverysimilartounadjustedeffectsizes.AsecondarypurposeofthisresearchwastoaddressthelackofexperimentalresearchdesignedtoassessthecausalimpactofSEonpainperception.InStudy2,samplesof84undergraduatewomenwererandomlyassessedthroughexperimentalmanipulationsinwhichtheyweregivenfalsefeedbackabouttheirperformanceonabaselinecoldpressortest.Participantsrandomlyassignedtothehighperformancecondition(n=27)weretold”Justbeforeyoudothesecondcoldpressortest,I’llgiveyoualittlefeedbackabouthowwellyouperformedonthefirstcoldpressortest.Iwon’ttellyoutheexactamountoftimeyoulastedbutIcansaythatyoulastedforalongertimethan91%ofpeoplewhohavedonethecoldpressortestatSWU.Youseemtobemorecapablethanmostpeopleatthetask”whilethoserandomlyassignedtothelowperformancecondition(n=30)weretold”Justbeforeyoudothesecondcoldpressortest,I’llgiveyoualittlefeedbackabouthowwellyouperformedonthefirstcoldpressortest.Iwon’ttellyoutheexactamountoftimeyoulastedbutIcansaythatyoulastedforlesstimethan91%ofpeoplewhohavedonethecoldpressortestatSWU.Youseemtobelesscapablethanmostpeopleatthetask”.Womenrandomlyassignedtotheaverageperformancecontrolcondition(n=27)weretold”Justbeforeyoudothesecondcoldpressortest,I’llgiveyoualittlefeedbackabouthowwellyouperformedonthefirstcoldpressortest.Iwon’ttellyoutheexactamountoftimeyoulastedbutIcansaythatyoulastedforasmuchtimeasexactlyhalfofpeoplewhohavedonethecoldpressortestatSWU.Youseemtohaveaveragecapabilitycomparedtootherpeopleatthetask”.ItwashypothesizedthatwomenassignedtothehighperformancefeedbackconditionwouldreportanincreaseinSEandshowasignificantimprovementinpaintoleranceonafollow-upCPTcomparedtowomeninthecontrolcondition.Furthermore,womenassignedtothelowperformancefeedbackconditionwereexpectedtoreportadecreaseinSEyetshowasignificantimprovementinpaintoleranceonafollow-upCPTcomparedtocontrols.RepeatedmeasureANOVAshowedthattherewassignificantinteractioneffectbetweenself-efficacyandcondition,F(2,81)=3.91,p=0.024.Specifically,SEchangedatthedifferentwayamonghighSEfeedback,lowSEfeedbackandaverageSEfeedback.RepeatedmeasureANOVAalsoshowedthattheoverallsampleratedpainintensityatthesamelevelonthe2ndCPTcomparedtothe1stCPT,F(1,81)=2.578,p=0.11.ThereisamarginalsignificantpaintolerancexConditioninteraction,F(2,81)=3.06,p=0.052.Basically,lowSEfeedbackresultedinalargerincreaseinpaintolerancebetweenbaselineandpost-feedbackCPT’scomparedtoaverageorhighSEfeedback.Theresultsofthisstudydidnotprovidedemonstrationofourpredictedeffect,SEfeedbackthatreducesself-efficacycanboostperformanceduringtheCPT.Basically,inresponsetolowSEfeedback;participantsloweredtheirself-efficacyandshowedincreasedlevelofperformance.
【作者】王雅磊;
【导师】ToddJackson;
【作者基本信息】西南大学,基础心理学,2014,硕士
【关键词】meta-analysis;self-efficacy;chronicpain;impairment;painseverity;emotionaldistress;experiment;paintolerance;face;

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