Measuring Pain Self-efficacy

Abstract

BACKGROUND: It is likely that people with chronic pain who have low self-efficacy have a worse prognosis. A standard, high-quality measure of self-efficacy in such populations would improve evidence, by allowing meaningful comparisons amongst subgroups and between treatments, and by facilitating pooling across studies in systematic reviews. OBJECTIVES: To identify self-administered pain-related self-efficacy measures used in people with chronic pain and to evaluate the clinimetric evidence of the most commonly used scales systematically. METHODS: We searched 2 databases to identify self-efficacy questionnaires. We evaluated questionnaires identified against previously developed criteria for clinimetric assessment. RESULTS: We identified 13 relevant measurements assessing self-efficacy, and clinimetrically assessed 5 of these. These questionnaires were the Arthritis Self-Efficacy Scale, the Chronic Disease Self-Efficacy Scale, the Pain Self-Efficacy Questionnaire, the Chronic Pain Self-Efficacy Scale, and the Self-Efficacy Scale. None of the questionnaires showed satisfactory results for all properties. All scales were easily scored and dimensionality was assessed in 2 of 6 of the scales. Internal consistency was acceptable for all questionnaires. There was positive evidence for construct validity in 4 of 6 of the questionnaires. None of the studies used the most up-to-date method of test-retest reliability or responsiveness. Information on interpretability of the scores was minimal in all questionnaires. DISCUSSION: Further research should focus on assessing responsiveness and interpretability of these questionnaires. Researchers should select questionnaires that are most appropriate for their study aims and population and contribute to further validation of these scales. Future research should measure outcome expectancy alongside self-efficacy to best predict future behavior.