{
  "abstract": "Background: Post-traumatic stress disorder (PTSD) and chronic pain frequently coexist, contributing to functional disability and social isolation. Aim: This study investigated whether pain self-efficacy mediates the relationship between fear-avoidance beliefs and social avoidance in individuals with comorbid PTSD and chronic pain. Methods: A descriptive correlational design was implemented. A purposive sample of 84 patients with chronic pain and comorbid PTSD was recruited from the Outpatient Pain Clinic of Menoufia University Hospital in Shebin El-Kom, Egypt. Data were collected using a structured interviewing questionnaire, completed validated self-report measures of the Fear-Avoidance Beliefs Questionnaire (FABQ), the Pain Self-Efficacy Questionnaire (PSEQ), Social Avoidance and Distress Scale (SADS), Posttraumatic Checklist for DSM-5 (PCL-5) and Visual Analogue Pain scale (VAS). Results: Lower pain self-efficacy was significantly predicted by fear-avoidance beliefs (β = -0.448, p <.001). Higher social avoidance and distress behavior were significantly correlated with lower pain self-efficacy (β = -0.564, p <.001). The indirect effect (a × b = 0.253) was statistically significant, as its 95% BCa bootstrap confidence interval [0.110, 0.461] did not cross zero, despite the fact that the total effect of fear-avoidance on social avoidance was significant (β = 0.379, p <.001). Demonstrating that the relationship between fear-avoidance beliefs and social avoidance is fully accounted for by pain self-efficacy. The final model accounted for 44.8% of the variance in social avoidance and distress behavior. Conclusion: Social avoidance in patients with comorbid PTSD and chronic pain is influenced by fear-avoidance beliefs, which are mediated by pain self-efficacy. Interventions that emphasize pain self-efficacy may mitigate social withdrawal and promote functional recovery. Recommendations: Psychiatric and pain-management nurses should integrate pain self-efficacy enhancement programs and cognitive-behavioral strategies into routine care to alleviate fear-avoidance beliefs and mitigate social isolation in this vulnerable population",
  "abstract_shown": true,
  "affiliations": [
    "Lecturer of Psychiatric & Mental Health Nursing, Faculty of Nursing-Menoufia University.",
    "Assistant Prof psychiatric mental health nursing, Faculty of Nursing, Cairo University, Egypt",
    "Lecturer of Psychiatric & Mental Health Nursing, Faculty of Nursing-Menoufia University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nehal Sobhy Emaraa"
    },
    {
      "affs": [
        1
      ],
      "name": "Abeer Taha Ahmed Taha"
    },
    {
      "affs": [
        2
      ],
      "name": "Rania Sobhy Elgendy"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/arwx6hc8pv0n7.bib",
  "cited_by": 0,
  "doi": "10.21608/ejhc.2026.534137",
  "fulltext_url": null,
  "id": "arwx6hc8pv0n7",
  "issns": [
    "3009-6766",
    "1687-9546"
  ],
  "landing_url": "https://doi.org/10.21608/ejhc.2026.534137",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RT1-120"
    ],
    [
      "openalex",
      "2736|Musculoskeletal pain and rehabilitation"
    ]
  ],
  "openalex": "W7222868936",
  "pdf_url": "https://ejhc.journals.ekb.eg/article_534137_089d94e32166aeac27bddcfb07ae23be.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "Ain Shams University, Faculty of Nursing",
  "ris": "https://research.draconitic.com/paper/arwx6hc8pv0n7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:09Z",
      "native_id": "e94bedcf1e264d16aef1605bada504ed",
      "source": "doaj",
      "url": "https://doi.org/10.21608/ejhc.2026.534137"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Musculoskeletal pain and rehabilitation",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Pain Self-Efficacy as a Mediator between Fear-Avoidance Beliefs and Social Avoidance among Individuals with Comorbid Post- Traumatic Stress Disorder and Chronic Pain",
  "title_text": "Pain Self-Efficacy as a Mediator between Fear-Avoidance Beliefs and Social Avoidance among Individuals with Comorbid Post- Traumatic Stress Disorder and Chronic Pain",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:09Z",
  "url": "https://research.draconitic.com/paper/arwx6hc8pv0n7",
  "venue": "Egyptian Journal of Health Care",
  "versions": []
}