PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION Original Research Article The Perceived Control Over Pain Construct and Functional Status April Hazard Vallerand, PhD, RN,* Jamie Crawley, PhD, RN, † Barbara Pieper, PhD, RN,* and Thomas N. Templin, PhD* *Wayne State University, College of Nursing, Detroit, Michigan, USA; † University of Windsor, Faculty of Nursing, Windsor, Canada Correspondence to: April Hazard Vallerand, PhD, RN, FAAN, Wayne State University College of Nursing, 5557 Cass Avenue, Detroit, MI 48202, USA. E-mail: April.vallerand@wayne.edu. Funding sources: This study was funded by a Wayne State University College of Nursing and Detroit Medical Center Faculty Scholar Award. Disclosure: The authors do not have any financial or other relationships that might lead to a conflict of interest. Abstract Introduction. Belief in one’s ability to control pain is a significant predictor of health outcomes and is related to improved functional status. The purpose of this study was to introduce a novel formulation of the construct, Perceived Control Over Pain and to test its effects on functional status. Methods. Participants (N 5 301) were primarily African American (92%); and were adults with low income attending a primary care clinic and report- ing pain within the past 2 weeks. A cross-sectional design was used with confirmatory factor analysis and structural equation modeling. The Perceived Control Over Pain construct consisted of four measures—two specific measures of control over pain and two general measures of control over life events. Perceived Control Over Pain has not been defined in this way previously. Results. Mean worst pain scores for the past week were 8.4, where “0” (no pain) to “10” (pain as bad as you can imagine). The model demonstrated good construct validity for the components of pain, Perceived Control Over Pain and functional status. Mediation by Perceived Control Over Pain was par- tial but strong, accounting for a reduction of 29% in the effect of pain on functional status. Discussion. In minority populations with low income, factors such as perceived control over pain and its effect on the outcome of patient function need to be considered. Improving Perceived Control Over Pain has the potential for improving patients’ feelings of life control and purpose or meaning in life, and psychological and physical functioning for adults living with pain. Key Words. Perceived Control Over Pain; Functional Status; Structural Equation Model Introduction Belief in one’s ability to control pain is a significant pre- dictor of health outcomes in patients with chronic pain and has been related to improved functional status and greater mental health [1–3]. However, a comprehensive measure of perceived control over pain has not been developed. Thompson [4] defined control as, “the belief that one has ... a response that can influence the averseness of an event,” and suggested it does not need to be exercised for effect, only perceived. In a study of experimental pain involving 64 men exposed to a controlled or uncontrolled pain stimulus, participants’ beliefs in lack of control over pain was significantly related to their reports of pain intensity [5]. Vancleef and Peters [6] examined the independent influence of per- ceived control over pain and self-efficacy beliefs on the subjective evaluation of pain in 79 healthy participants using electrical stimulation. High self-efficacy regarding the ability to exert control over pain resulted in a signifi- cant reduction in anticipated pain intensity, anticipated pain unpleasantness, and experienced pain intensity V C 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 692 Pain Medicine 2016; 17: 692–703 doi: 10.1111/pme.12924 Downloaded from https://academic.oup.com/painmedicine/article-abstract/17/4/692/2584074 by guest on 02 June 2020