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 −”)