The Serial Mediating Roles of Pain Acceptance and Pain Self-Efficacy in the Relationship Between Concerns About Pain and Well-Being in Pain Among Individuals With Chronic Pain: A Structural Equation Modeling Study

Numerical Rating Scales (NRS): In alignment with the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11), participants' pain intensity over the past week, the impact of pain on daily activities, and the level of pain-related distress will be assessed separately using 0-10 numerical rating scales. Pain intensity will be rated from 0 ("no pain") to 10 ("worst pain imaginable"); the impact of pain on daily life from 0 ("no impact") to 10 ("completely prevents my activities"); and pain-related distress from 0 ("no distress") to 10 ("extreme distress").

University of Washington Pain-Related Worry Scale: This scale was developed to assess individuals' pain-related worries and their levels of pain catastrophizing. The scale consists of a total of 6 items. The items inquire about the individual's thoughts regarding pain over the past seven days and are rated using a five-point Likert-type scale with the options: "Never" (1 point), "Rarely" (2 points), "Occasionally" (3 points), "Often" (4 points), and "Always" (5 points). Total scores on the scale range from 6 to 30. There are no reverse-scored items or established cut-off points for the scale. A higher total score indicates increased pain-related worry and a higher level of pain catastrophizing. When necessary, the raw total score can be converted to a T-score using the scale's conversion table. In the study regarding the Turkish validity and reliability of the scale, the Cronbach's alpha value was reported as 0.85.

Chronic Pain Acceptance Questionnaire-Short Form: The scale assesses an individual's level of acceptance regarding the pain experience and their ability to maintain daily life in the presence of pain, shifting away from the constant struggle to control or eliminate it. The scale consists of 8 items and encompasses the dimensions of activity engagement and pain willingness/acceptance. The Turkish validity and reliability study of the scale was conducted by Zure et al. in 2022. Cronbach's alpha values for the scale were found to be 0.76 and 0.80, respectively. The scale utilizes a six-point Likert-type format, with scores ranging from 0 to 48. Higher scores indicate that the patient has a greater acceptance of the pain and copes with it more effectively.

The University of Washington Pain-Related Self-Efficacy Scale-Short Form is a 6-item scale developed to assess patients' perceptions regarding their self-efficacy-or confidence-in performing daily, social, and personal activities despite pain. Each item is rated on a 5-point Likert-type scale ranging from 1 ("not at all confident") to 5 ("completely confident"). Total scores on the scale range from 6 to 30, with higher scores indicating a higher level of pain-related self-efficacy. The Cronbach's alpha value was reported as 0.87 in the study regarding the Turkish validity and reliability of the scale.

This scale was developed to assess well-being in the presence of pain among individuals with chronic pain, as well as the psychological, social, and lifestyle-related characteristics that support such well-being. The scale consists of a total of 11 items rated on a 5-point Likert scale ranging from 0 ("never") to 4 ("almost always"). The total score is calculated by summing the responses to all items and ranges from 0 to 44. Higher scores indicate a higher level of pain-related well-being; a score of 0 represents the minimum level, while a score of 44 represents the maximum level of pain-related well-being. In the study regarding the Turkish validity and reliability of the scale, the Cronbach's alpha value was reported as 0.713.