BACKGROUND Persistent pain has a high prevalence among adolescents. Pain has been shown to reduce all aspects of the adolescent's health-related quality of life (HRQOL). In adult patients with pain, self-efficacy has been shown to mediate the relationship between pain intensity, disability and depression. However, little is known about whether self-efficacy acts as a mediating variable in the relationship between persistent pain and HRQOL sub-scale scores in a school-based population of adolescents. OBJECTIVES To describe the experience of pain, HRQOL and self-efficacy, and to explore the association between pain intensity, general self-efficacy and HRQOL in adolescents with persistent pain by testing self-efficacy as a possible mediator. METHODS The study participants were 78 adolescents with persistent pain, aged 16-19 years, who were recruited from five high schools in southern Norway. All participants completed an electronic survey consisting of the Lubeck Pain Questionnaire, which included a visual analogue scale (VAS) measuring pain intensity, the General Self-Efficacy Scale (GSE) and the KIDSCREEN-52 Questionnaire measuring HRQOL. Statistical analyses were conducted using the PROCESS macro for SPSS developed by Andrew Hayes. RESULTS All participants reported pain in multiple locations, of which the head was most common (88.5%). Mean (SD) pain intensity score of the participants was 5.4 (1.8). The study sample had poor HRQOL, with mean (SD) scores for several sub-scales ranging from 45.2 (21.0) to 91.0 (13.3) on a 0-100 scale. The associations between pain intensity and the HRQOL sub-scales of physical well-being, psychological well-being, mood, self-perception, autonomy and school environment were mediated by self-efficacy. The highest degree of mediation and, thus, the largest indirect effect was estimated for the HRQOL sub-scale physical well-being (67.2%). CONCLUSIONS This school-based sample of adolescents with persistent pain had impaired HRQOL. Up to 67% of the reduction in the HRQOL sub-scale scores for physical well-being, psychological well-being, mood, self-perception, autonomy and school environment could be explained by the mediating variable self-efficacy. Thus, future pain-management interventions that aim to increase HRQOL in school-based populations of adolescents with persistent pain should consider promoting self-efficacy and providing more targeted interventions. TRIAL REGISTRATION ClinicalTrials.gov ID NCT03551977.

中文翻译：

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持续疼痛与自我效能的中介作用与青少年健康相关的生活质量：一项横断面研究。

背景技术持久性疼痛在青少年中普遍存在。研究表明，疼痛会降低青少年健康相关生活质量（HRQOL）的所有方面。在患有疼痛的成年患者中，自我效能已被证明可介导疼痛强度，残疾和抑郁之间的关系。然而，对于以学校为基础的青少年群体中持续性疼痛与HRQOL子量表分数之间的关系，自我效能是否充当中介变量知之甚少。目的通过测试自我效能感作为可能的介体，来描述疼痛，HRQOL和自我效能感的经历，并探索持续性疼痛青少年的疼痛强度，一般自我效能感和HRQOL之间的关系。方法研究对象为78名16-19岁的持续性疼痛青少年，他们是从挪威南部的五所中学招募的。所有参与者均完成了由吕贝克疼痛问卷组成的电子调查，该问卷包括测量疼痛强度的视觉模拟量表（VAS），一般自我效能量表（GSE）和测量HRQOL的KIDSCREEN-52问卷。使用Andrew Hayes开发的SPSS的PROCESS宏进行统计分析。结果所有参与者均报告了多个部位的疼痛，其中头部最常见（88.5％）。参与者的平均（SD）疼痛强度评分是5.4（1.8）。研究样本的HRQOL较差，几个子量表的平均（SD）评分在0-100量表上从45.2（21.0）到91.0（13.3）不等。疼痛强度与身体健康，心理健康，情绪，自我感知，自主性和学校环境由自我效能感调节。估计HRQOL子量表的身体健康水平最高，为中介水平，因此间接影响最大（67.2％）。结论该校本持续性疼痛青少年的HRQOL受损。HRQOL子量表在身体健康，心理健康，情绪，自我知觉，自主权和学校环境方面的得分降低最多达67％，这可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。估计HRQOL子量表的身体健康水平最高，为中介水平，因此间接影响最大（67.2％）。结论该校本持续性疼痛青少年的HRQOL受损。HRQOL子量表在身体健康，心理健康，情绪，自我知觉，自主权和学校环境方面的得分降低最多达67％，这可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。估计HRQOL子量表的身体健康水平最高，为中介水平，因此间接影响最大（67.2％）。结论该校本持续性疼痛青少年的HRQOL受损。HRQOL子量表在身体健康，心理健康，情绪，自我知觉，自主权和学校环境方面的得分降低最多达67％，这可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。结论该校本持续性疼痛青少年的HRQOL受损。HRQOL子量表在身体健康，心理健康，情绪，自我知觉，自主权和学校环境方面的得分降低最多达67％，这可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。结论该校本持续性疼痛青少年的HRQOL受损。HRQOL子量表在身体健康，心理健康，情绪，自我知觉，自主性和学校环境方面的得分降低最多达67％，这可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。自主性和学校环境可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。自主性和学校环境可以通过中介变量自我效能来解释。因此，未来旨在增加持续性疼痛的学校青少年的HRQOL的疼痛管理干预措施应考虑提高自我效能，并提供更有针对性的干预措施。试验注册ClinicalTrials.gov ID NCT03551977。