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Updated: Jan 7, 2026
Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Do Pain Acceptance and Self-Management Contribute to Chronic Pain Adjustment? A Cross-Sectional Study
1School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
Objective:
To explore the chain mediating role of pain acceptance and self-management behavior between antecedent factors and pain adjustment outcomes. Antecedent factors included pain intensity, pain fear-avoidance, pain catastrophizing and self-efficacy, and pain adjustment outcomes were identified as disability and physical and mental well-being.
Design:
A cross-sectional study.
Methods:
A purposive sampling investigation was performed, recruiting a cohort of 261 patients with chronic pain. Self-reported measurements were used to assess pain acceptance, self-management behavior, antecedent factors and pain adjustment outcomes, and structural equation modeling analysis was performed.
Results:
Self-management behavior demonstrated non-significant associations with pain acceptance and pain adjustment outcomes, it was therefore removed from the hypothesized model. A revised model indicated that pain (β = -0.191, p < .001), pain fear-avoidance (β = -0.442, p < .001) and pain catastrophizing (β = -0.328, p < .001) had direct negative effects on pain acceptance while self-efficacy (β = 0.375, p < .001) showed a positive effect. Meanwhile, pain acceptance demonstrated a noteworthy improvement on health outcomes, manifested by less disability (β = -0.519, p < .001) and better physical well-being (β = 0.492, p < .001) and mental well-being (β = 0.622, p < .001). Pain acceptance significantly mediated the associations between antecedent factors and pain adjustment outcomes. In additional analysis, as two dimensions of pain acceptance, pain willingness (β = -0.281, p < .001) and activity engagement (β = 0.301, p < .001) exhibited opposite associations with self-management behavior, and both of them predicted less disability and improved physical and mental well-being.
Conclusion:
Influenced by multiple antecedent factors, pain acceptance has a significant potential value in enhancing pain adjustment outcomes; however, self-management does not show a positive role in the process. Culture-specific and scientific interventions should be developed to incorporate pain acceptance notion in self-management programs.
