Prediction of pain outcomes in Korean older adults: use of a structural equation model

To construct a structural equation model of pain adjustment outcomes (e.g., depression and fatigue) in Korean older adults based on the cognitive-behavioral model of chronic pain.

Nonexperimental research design. Data were collected by questionnaires from 271 Korean older adults. Data analysis was conducted with SPSS 10.1 for descriptive statistics and a PC-LISREL program for covariance structural analysis.

In this study, based on the modifications, chi-square statistics were changed, the goodness-of-fit index was 0.97, the adjusted goodness-of-fit index was 0.93, the root mean square residual was 0.04, the normal fit index was 0.98, and the non-normed fit index was 0.98. Path coefficients and their statistical significance for the revised model were as follows: pain adjustment and pain beliefs were found to have a significant direct effect on pain coping. The variable directly related to pain beliefs was pain adjustment, and variables directly influencing fatigue were pain coping and pain beliefs. Lastly, pain adjustment, pain coping, and fatigue were found to have a significant direct effect on depression. Also, pain adjustment, pain coping, and pain beliefs were found to have a significant indirect effect on depression. In conclusion, pain adjustment, pain coping, pain beliefs, and fatigue all contributed to depression. Fifty-four percent of depression could be explained by these variables.

This modified model is considered appropriate for explaining and predicting pain adjustment outcomes in Korean older adults. Also, the findings support the development of an intervention strategy to improve pain coping, negative pain beliefs, fatigue, and depression caused by poor pain adjustment.