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The Mediating Role of Pain Catastrophizing on the Association Between Depression and Pain Severity and Interference Among Elderly Asian Immigrants with Chronic Pain

Authors Kim HJ, Park H, Juon HS

Received 29 January 2021

Accepted for publication 26 February 2021

Published 12 March 2021 Volume 2021:14 Pages 737—745


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Jonathan Greenberg

Hee Jun Kim,1 Hyunjeong Park,2 Hee-Soon Juon3

1Research Institute of Nursing Science, College of Nursing, Ajou University, Suwon, 16499, Republic of Korea; 2Department of Nursing, Towson University, Towson, MD, 21252, USA; 3Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, 19107, USA

Correspondence: Hee Jun Kim
Research Institute of Nursing Science, College of Nursing, Ajou University, 206 World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Republic of Korea
Tel +82 31-219-7024
Fax +82 31-219-7020
Email [email protected]

Purpose: The association between depression and chronic pain is well established. However, few studies have examined the pathways from depression to chronic pain. The present cross-cultural study aimed to test the mediating effects of pain catastrophizing on associations between depression and chronic pain (eg, pain severity, pain intensity) among Korean American elderly.
Patients and Methods: A total of 132 elderly Korean Americans with chronic pain were recruited from elderly daycare centers and Korean ethnic churches in the community. For mediation analyses, structural equation modeling with full information maximum likelihood estimation method was used. The bias-corrected bootstrap confidence interval (CI) method for inferential tests of the indirect effects was also conducted in mediation analysis.
Results: The results indicated that the proportion of comorbid depression and chronic pain was 45.7%. Elderly Korean Americans with depression scored higher in pain severity, pain interference, and pain catastrophizing than those without depression. Pain catastrophizing was found to have a significant mediating effect on the relationship between depression and pain severity (indirect effect = 0.147, Bootstrap 95% CI = [0.079, 0.226]), controlling for demographic covariates, comorbidities and pain area. Pain catastrophizing also mediated the relationship between depression and pain interference (indirect effect =0.164, Bootstrap 95% CI = [0.097, 0.244]), controlling for the covariates.
Conclusion: These findings add to the literature by providing evidence that pain catastrophizing plays a role in high levels of pain severity and pain interference comorbid chronic pain and depression in Asian elderly immigrants. Appropriate culturally tailored programs to redirect pain catastrophizing cognitive process should be developed and provided for elderly Asian Americans to reduce chronic pain disparity.

Keywords: Korean immigrants, cross-cultural, comorbid, mediation

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