Self-efficacy and commitment as psychological resources to adherence to walking despite chronic pain. A study on women with fibromyalgia

Background: Personal resources are key in adherence to treatment in patients with chronic pain. The aim of this study was to analyze the mediating effect of self-efficacy and commitment to physical exercise between the severity of pain and the number of times a week the patient has gone for a fast walk for at least 30 minutes with the aim of doing physical exercise, in women with fibromyalgia. Method: A total of 264 women with fibromyalgia participated in the study. The mean age was 56.99 years (SD = 10.35). Pain intensity, self-efficacy to cope with chronic pain, commitment to physical exercise and the number of times a week that the patient walked for at least 30 minutes with the goal of physical exercise were evaluated. For data analysis, the serial multiple mediator model of the macro Process for SPSS 22 was used. Results: A lower perception of pain was associated with a higher perception of self-efficacy, a higher perception of self-efficacy was associated with a greater commitment to physical exercise, and a higher commitment was associated with a greater number of times a week that they walked (B = -.34; SE = .20; 95% CI = [-0.83, -0.03]). A total effect (B = -1.04, SE = .38, t = -2.78, 95% I = [-1.81, -.78], p = .01) of the predictors on the described behavior pattern was observed. Conclusion: Self-efficacy and commitment to the physical exercise mediate the relationship between pain intensity and the described walking pattern. The results of the serial mediation indicate that self-efficacy is an essential variable for the performance of commitment to the physical exercise in the relationship between pain intensity and walking.