Psychosocial factors important for physical activity participation among adults living with chronic pain
Date
2019-07-29
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
Type
Thesis
Degree Level
Doctoral
Abstract
Background. This dissertation is comprised of three studies that are presented in manuscript-style and connected through bridging sections. Physical activity is considered beneficial and recommended for adults living with chronic pain. Given that low participation rates exist, research must be conducted on identifying modifiable factors related to physical activity participation. Individual-level, modifiable psychosocial factors examined in this dissertation fell within three overarching domains of: (a) pain intensity and pain-related outcomes of fatigue, disability, and depressive symptoms; (b) maladaptive responses to chronic pain (i.e., pain anxiety, maladaptive responses to pain anxiety); and (c) adaptive responses to chronic pain (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility). The overall purpose of this program of research was to gain a better understanding of the psychosocial factors associated with physical activity, including whether the factors differentiated physical activity levels. Study 1. The purpose was to examine whether adults living with chronic pain from arthritis who were insufficiently or sufficiently active in meeting the public health recommendation for moderate-vigorous physical activity significantly differed in their maladaptive responses and psychological flexibility. Participants were 136 adults with self-reported arthritis who completed two online surveys. The psychosocial variables were assessed at Time 1 and moderate-vigorous physical activity, two weeks later, at Time 2. Sufficiently active (n = 87) and insufficiently active (n = 49) groups were identified. A significant MANCOVA (p = .04) with univariate follow-up tests illustrated that sufficiently active participants reported significantly higher psychological flexibility and used maladaptive responses significantly less often compared to insufficiently active participants (p’s < .05). Pain anxiety did not differ (p = .17). Study 2. The purpose was to examine whether adults living with chronic pain who were sufficiently active, insufficiently active, or inactive significantly differed in their pain anxiety, psychological flexibility, and SRE-pain. A secondary purpose was to examine whether the three activity groups differed in pain-related outcomes. Adults with self-reported chronic pain for 6+ months (N = 318) were included in this cross-sectional online study. Sufficiently active (n =139), insufficiently active (n = 91), and inactive (n = 88) groups were identified. A significant MANCOVA (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p’s < .001). Insufficiently active individuals reported significantly higher SRE-pain than the inactive participants (p < .001). Relative to the secondary purpose, a significant MANCOVA (p = .001) with univariate follow-up tests illustrated that inactive individuals reported significantly higher levels of pain disability and fatigue compared to the sufficiently active. Insufficiently active individuals also reported greater fatigue compared to their sufficiently active counterparts. Depressive symptoms did not significantly differ between the three groups. Study 3. The purpose was to examine whether SRE-pain mediated the psychological flexibility – physical activity relationship among adults living with chronic pain for 6+ months (N = 193). Participants completed online surveys, every two weeks. Findings illustrated that Time 2 SRE-pain partially mediated the relationship between Time 1 psychological flexibility and Time 3 physical activity. Conclusions. Findings contributed new information on how adults’ responses to their chronic pain related to or differentiated physical activity levels, as well as identifying a possible mechanism that might be involved in explaining how psychological flexibility partially operates to relate to physical activity. Findings may help to inform future research aimed at identifying which responses to pain are the most critical to target when individuals are trying to progress from one activity level to another.
Description
Keywords
physical activity, chronic pain, psychosocial factors, psychological flexibility, pain anxiety, self-regulatory efficacy
Citation
Degree
Doctor of Philosophy (Ph.D.)
Department
Kinesiology
Program
Kinesiology