Do Psychological Factors Explain the Persistence of Symptoms in Individuals With Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study
Bibliographic record
Abstract
OBJECTIVE: To determine whether psychosocial factors such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with RCRSP following an education program. METHODS: One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included two meetings with a physiotherapist. After 12 and 24-weeks, participants filled only pain and disability questionnaires and based on their scores, were classified as having persistent shoulder pain or as recovered. RESULTS: A univariable modified Poisson regression showed that higher perceived stress (RRadjusted: 1.02; 95%CI: 1.01-1.04), catastrophizing (RRadjusted: 1.01; 95%CI: 1.01-1.02), symptoms of depression (RRadjusted: 1.03; 95%CI: 1.01-1.06) and anxiety (RRadjusted: 1.03; 95%CI: 1.01-1.06), along with lower resilience (RRadjusted: 0.90; 95%CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. Additionally, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RRadjusted: 0.98; 95%CI: 0.97-0.99) and 24 weeks (RRadjusted: 0.99; 95%CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RRadjusted: 0.98; 95%CI: 0.97-0.99). DISCUSSION: This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".