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. 2020 Jul 9;19:102. doi: 10.1186/s12904-020-00606-0

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© The Author(s) 2020

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Path diagram for structural equation modeling of the constructive concept. Numerical value:Path coefficient, □:Observation variable, ○:Latent variable, →:Causality, ⓔ:Error. JBQ-II, Japanese Version of the Barriers Questionnaire II (total score, higher scores indicating stronger barriers); PMI, Pain Management Index (−3 to + 3, lower scores indicating inadequate pain management); Pain, pain +/− (dummy variable of 1 for “pain +”); subjective health, healthy/not healthy (dummy variable of 1 for “not healthy”); K6, Six-Item Kessler Psychological Distress Scale (total score, high scores indicate high levels of psychological distress.); BPI-J, Japanese version of the Brief Pain Inventory (total score, higher scores indicate stronger interference in daily life); Side effect, side effect of analgesics +/− (dummy variable of 1 for “side effect −”)