Evaluation of the fear-avoidance model with health care workers experiencing acute/subacute pain.

Studies in the literature do not show clear evidence supporting the relationship between pain and depressive symptoms in individuals experiencing acute/subacute pain compared to those experiencing chronic pain. However, more information is needed about which variables act as mediators in the pain-depression relationship in people having acute/subacute pain, before pain becomes chronic. Our objectives were to test the suitability of the fear-avoidance model in a sample of 110 health care workers experiencing acute/subacute pain using path analyses, to improve the model as needed, and to examine a model involving both pain catastrophizing and pain self-efficacy with work status as a final outcome. Overall, the results indicated that adjustments to the fear-avoidance model were required for people experiencing acute/subacute pain, in which fear-avoidance beliefs and depressive symptoms were concurrent rather than sequential. The catastrophizing concept was most closely associated with depressive symptoms, while pain self-efficacy was directly associated with fear-avoidance beliefs and indirectly to work outcomes. Assessing and modifying pain self-efficacy in acute/subacute pain patients is important for interventions aiming to decrease fear-avoidance and improve work outcomes.