Designing a Conceptual Model of Mood and Anxiety Symptoms with Quality of Life and Pain Outcomes in Patients with Chronic Back Pain: The Mediating Role of Emotional Schemas and Self-Compassion.

Various psychological factors, including mood and anxiety symptoms, can affect pain outcomes and quality of life. Therefore, the aim of the present study was to design a conceptual model of mood and anxiety symptoms with quality of life and pain outcomes in patients with chronic back pain and the mediating role of emotional schemas and self-compassion.

The research method of the present study is descriptive-correlation. The statistical population consisted of women and men aged 30-50 with chronic back pain and referred to pain clinics in Akhtar, Labbafinezhad and Imam Hossein (AS) hospitals in Tehran in 2019-2020. 400 people were selected by purposeful and convenience sampling method considering the entry and exit criteria. Data collection instruments are demographic questionnaire, "Mood and Anxiety Symptoms Questionnaire", "World Health Organization Quality of Life Assessment (WHOQOL-BREF)", " Consequences of Pain Questionnaire” and “Self-Compassion Scale- Short Form”. The construct validity of the instruments was checked and confirmed by confirmatory factor analysis method and reliability by internal consistency method by calculating Cronbach's alpha coefficient. Data analysis was done in SPSS. 21 and LISREL 8.8.

The model showed a favorable fit, mood and anxiety symptoms have a direct, positive and significant correlation with the increase in emotional schemas (P<0.05). Emotional schemas have a direct, negative and significant correlation with the reduction of self-compassion (P<0.05). Also, mood and anxiety symptoms have an indirect, positive and significant correlation with the increase in pain outcomes and a negative and significant indirect correlation with the decrease in quality of life (P<0.05).

Results supported the mediation of self-compassion between emotional symptoms and emotional schemas with pain outcomes and quality of life. Therefore, it is suggested to use the findings of the present study in treatment programs.