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Patient Educ Couns. 2011 Nov;85(2):275-80. doi: 10.1016/j.pec.2010.11.007. Epub 2010 Dec 15.

Associations between pain control self-efficacy, self-efficacy for communicating with physicians, and subsequent pain severity among cancer patients.

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  • 1Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817, USA.



Coaching patients to be more active in health encounters may improve communication with physicians but does not necessarily improve health outcomes. We explored this discrepancy by examining relationships between self-efficacy for communicating with physicians and pain control self-efficacy and subsequent pain severity among cancer patients participating in a coaching trial.


We analyzed data from 244 English-speaking adults with various cancer types reporting significant pain, recruited from 49 oncology physicians' offices. Mixed model linear regression examined relationships between post-intervention communication self-efficacy and pain control self-efficacy and subsequent pain severity over 12 weeks.


Post-intervention pain control self-efficacy (but not communication self-efficacy) was significantly related to subsequent pain severity: a one standard deviation increase was associated with a 0.19 point decrease (95% confidence interval=-0.33, -0.04; p=0.01) in pain severity over time, approximately 25% of the effect size of the influence of post-intervention pain on subsequent pain.


Among cancer patients enrolled in a coaching trial, post-intervention pain control self-efficacy, but not communication self-efficacy, was significantly related to subsequent pain severity.


Identifying behavioral mediators of cancer pain severity may lead to coaching interventions that are more effective in improving cancer pain control.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[PubMed - indexed for MEDLINE]
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