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

Objective: 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. Methods: 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. Results: 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. Conclusion: 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. Practice implications: Identifying behavioral mediators of cancer pain severity may lead to coaching interventions that are more effective in improving cancer pain control.