Questionnaire PSEQ 11 Oct 2024

Pain Self-Efficacy Questionnaire

International Knee Documentation Committee (IKDC)

Pain Self-Efficacy Questionnaire (PSEQ)

Pain self-efficacy is described as one’s confidence in their ability to do activities and achieve goals despite the presence of symptoms or pain (Nicholas et al., 2007). It is important to consider the level of self-efficacy in someone experiencing musculoskeletal pain since higher levels of pain self-efficacy have been proposed as a predictor of a better outcome (Martinez-Calderon et al., 2018).

Higher self-efficacy levels are associated with greater physical functioning, physical activity participation, health status, work status, satisfaction with the performance, efficacy beliefs, and lower levels of pain intensity, disability, disease activity, depressive symptoms, presence of tender points, fatigue, and presenteeism (Martinez-Calderon et al., 2018). Measuring and improving someone’s self-efficacy may therefore be important throughout rehabilitation.

The Pain Self-Efficacy Questionnaire (PSEQ) is one of the most used self-efficacy questionnaires in clinical settings for musculoskeletal disorders (Dubé et al., 2021). A recent Delphi study preferred the use of this questionnaire for assessing self-efficacy over 4 other possible questionnaires (Sleijser-Koehorst et al., 2019).

 

Validity and Reliability

The PSEQ has excellent validity, reliability, and responsiveness in populations with musculoskeletal disorders. The PSEQ has been adapted and validated in 14 languages (Dubé et al., 2021).

Both structural validity and content validity of the PSEQ are strong. Construct validity reveals low to moderate relationships with measures of quality of life, disability, pain, pain interference, anxiety, depression, and catastrophizing. Both internal consistency and test-retest reliability are very good (Dubé et al., 2021).

The PSEQ is responsive to clinically significant change over time. PSEQ was more sensitive than the other scales, in assessing change in patients with persistent LBP after participating in a back rehab program (Maughan et al. 2010).

 

 

Scoring and Interpretation

The PSEQ questionnaire consists of 10 items (PSEQ-10) rated from 0 (not at all confident) to 6 (completely confident). The total score ranges from 0 to 60 with higher scores indicating stronger self-efficacy belief, meaning the person is more confident in their ability to function despite the pain.

Pooled estimates of the minimal detectable change (MDC =11.52) and Standard Error of Mean (SEM =3.37) were found to be satisfactory. Patients with chronic low back pain had MCIDs ranging from 5.5 to 8.5 out of 60 points (Chiarotto et al. 2016), while in another study by Maughan et al. (2010) a change of 9 to 11 points on the PSEQ corresponded to the MCID, which is lower than the MDC, indicating that researchers and clinicians can utilize the MDC to gauge change. Based on these findings, practitioners can confidently administer the questionnaire to assess patients’ pain self-efficacy (Dubé et al., 2021).

More recently, abbreviated versions of the PSEQ were developed, where only 2 or 4 questions must be answered. The PSEQ-2 appears to be a robust measure of pain self-efficacy and may be suitable for use in clinical and research settings (Nicholas et al., 2015).

The PSEQ-2 and the PSEQ-4 for chronic low back pain showed MCIDs of 1.5 points (Chiarotto et al. 2016). The sensitivity of the PSEQ-2 is reported to be 50.7% and the specificity 84.4%. For the PSEQ-4, sensitivity values increased to 80.3% and specificity was 68.7% (Chiarotto et al. 2016).

 

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References

Nicholas MK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain. 2007 Feb;11(2):153-63. doi: 10.1016/j.ejpain.2005.12.008. Epub 2006 Jan 30. PMID: 16446108. 

Nicholas MK, McGuire BE, Asghari A. A 2-item short form of the Pain Self-efficacy Questionnaire: development and psychometric evaluation of PSEQ-2. J Pain. 2015 Feb;16(2):153-63. doi: 10.1016/j.jpain.2014.11.002. Epub 2014 Nov 14. PMID: 25463701.

Dubé MO, Langevin P, Roy JS. Measurement properties of the Pain Self-Efficacy Questionnaire in populations with musculoskeletal disorders: a systematic review. Pain Rep. 2021 Dec 21;6(4):e972. doi: 10.1097/PR9.0000000000000972. PMID: 34963996; PMCID: PMC8701870. 

Martinez-Calderon J, Zamora-Campos C, Navarro-Ledesma S, Luque-Suarez A. The Role of Self-Efficacy on the Prognosis of Chronic Musculoskeletal Pain: A Systematic Review. J Pain. 2018 Jan;19(1):10-34. doi: 10.1016/j.jpain.2017.08.008. Epub 2017 Sep 20. PMID: 28939015. 

Sleijser-Koehorst MLS, Bijker L, Cuijpers P, Scholten-Peeters GGM, Coppieters MW. Preferred self-administered questionnaires to assess fear of movement, coping, self-efficacy, and catastrophizing in patients with musculoskeletal pain-A modified Delphi study. Pain. 2019 Mar;160(3):600-606. doi: 10.1097/j.pain.0000000000001441. PMID: 30422871; PMCID: PMC6407805.

Chiarotto A, Vanti C, Cedraschi C, Ferrari S, de Lima E Sà Resende F, Ostelo RW, Pillastrini P. Responsiveness and Minimal Important Change of the Pain Self-Efficacy Questionnaire and Short Forms in Patients With Chronic Low Back Pain. J Pain. 2016 Jun;17(6):707-18. doi: 10.1016/j.jpain.2016.02.012. Epub 2016 Mar 11. PMID: 26975193. 

Maughan EF, Lewis JS. Outcome measures in chronic low back pain. Eur Spine J. 2010 Sep;19(9):1484-94. doi: 10.1007/s00586-010-1353-6. Epub 2010 Apr 17. PMID: 20397032; PMCID: PMC2989277.


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