Table 4.

Reduction in HRQOL subscales in adolescents with persistent pain explained by direct (pain intensity) and indirect (self-efficacy and self-esteem) effects

	Direct effect	Indirect effect of self-efficacy	Indirect effect of self-esteem	Total indirect effecta
Physical well-beingb	54.2%	13.7%	32.1%*	45.8%*
Psychological well-beingb	35.4%	5.7%	58.8%*	64.6%*
Autonomy and parent relationb	–	–	–	–
Social support and peersb	–	–	–	–
School environmentb	26.5%	20.5%	53.0%*	73.5%*

HRQOL health-related quality of life

^*Statistically significant; the 95% confidence interval for the effect did not include zero

^aThe specific indirect effect of self-efficacy + the specific indirect effect of self-esteem (a₁b₁ + a₂b₂)

^bKIDSCREEN subscales