Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis

Abstract

Background Pain-related self-efficacy is defined as the beliefs held by people with chronic pain that certain activities can be carried out despite the pain. Poor self-efficacy is an obstacle to the recovery and predicts long-term disability. The aims of this study are to investigate the prevalence of poor pain self-efficacy in Italian subjects with chronic low back pain (LBP), and to inquire the relationships between self-efficacy, disability, pain, and main demographic and clinical characteristics. Methods A secondary multicenter retrospective analysis was done on 310 outpatients with chronic non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire (PSEQ), the disability measured with the Roland & Morris Disability Questionnaire, and the pain intensity measured with the Numerical Rating Scale were considered variables to investigate, whereas demographic and clinical variables were considered predictors or potential confounders. A 40/60 PSEQ score was adopted as cut-off to distinguish between good and poor self-efficacy. Results 199 subjects (64.2% of the sample) showed poor self-efficacy. The odds of having poor self-efficacy appeared significantly related to female gender (OR = 1.80, 95%CI [1.12;2.90]; p = 0.015) and drugs use (OR = 1.68, 95%CI [1.06;2.70]; p = 0.029). Significant relationships also emerged between disability and higher age (β = 0.07, 95%CI [0.01; 0.12]; p = 0.02), being female (β = 1.80, 95%CI [0.32;3.29]; p = 0.018), low educational level (β = − 1.68, 95%CI [− 2.59;-3.29]; p < 0.001), higher height (β = − 0.08, 95%CI [− 0.158;-0.002]; p = 0.045), pain duration [mos] (β = 0.01, 95%CI [0.001;0.021]; p = 0.041), and drugs use (β = 2.86, 95%CI [1.44;4.27]; p < 0.001). The amount of pain appeared significantly related to educational level (β = − 0.47, 95%CI [− 0.76;-0.182]; p < 0.001), smoking (β = 0.56, 95%CI [0.09; 1.03]; p = 0.021), height (β = − 0.03, 95%CI [− 0.05; − 0.002]; p = 0.036), and drugs use (β = 0.81, 95%CI [0.399;1.22]; p < 0.001). No significant correlation appeared among weight, body mass index, and referred pain neither in relation to self-efficacy, nor in relation to pain/disability. Conclusions The majority of our sample, composed of Italian people complained of chronic LBP, shows poor self-efficacy. Female gender and drugs use are significantly related to poor self-efficacy, low educational level negatively influences the amount of perceived pain and disability, and older age and smoking are related to disability and pain intensity, respectively. The knowledge of these sociodemographic and clinical characteristics potentially influencing chronic LBP may be useful to address more efforts towards the most negatively impacted subjects, among the entire population complained of chronic LBP.

Psychometric validation of the Chinese version of job-seeking self-efficacy scale for people with disabilities: A preliminary study

“…This result implies that the association between level of disability and job-seeking self-efficacy may be non-linear. The positive association between higher education level and higher self-efficacy (Ferrari et al, 2019) was also significant in the study, especially for those with post-secondary education. Similarly, people with self-reported professional skills had significantly higher self-efficacy than did those without.…”

Cross-cultural translation, adaptation, and validation of the Amharic version pain self-efficacy questionnaire in people with low back pain in Ethiopia

“…Evidence suggests that there are important clinical and experiential pain differences attributed to sex and gender [ 71 , 72 ]. While the reliability estimates were high in both men and women, a disaggregated analysis by sex shows that Physical Functioning, Social Functioning, Bodily Pain, Emotional Wellbeing, and General Health Perception of the SF-36 subscales were moderately correlated with PSEQ-Am among men with LBP.…”

“…The mechanism underlying this difference between men and women is unclear. Such a difference in the correlation between PSEQ-Am and SF-36 subscales could be related to sex or gender role differences in pain perception and expression [ 71 , 72 ]. Future studies involving Rasch analysis to look at differential item functioning (DIF) of the tool based on sex of the participants in the Ethiopian sample of LBP may help to understand these sex or gender differences.…”

“…However, PSEQ-Am may measure pain self-efficacy with other underlying constructs among people with LBP in Ethiopia which require further investigation. As discussed in previous literature, several psychosocial and cultural factors may affect one’s perception of abstract concepts such as pain [ 73 ] and self-efficacy [ 71 ]. Future studies are needed to evaluate psycho-social and cultural factors which may influence pain self-efficacy constructs among people with LBP in Ethiopia.…”

Assessment of measurement properties of the Brazilian-Portuguese version of the low back activity confidence scale (LoBACS) in patients with chronic low back pain

“…CLBP is attributed to intricate biopsychosocial mechanisms and multiple risk factors [3,4]. Several studies have evaluated the relationship between CLBP and self-efficacy (individual's confidence in their ability to perform a task) and found that cognitive tests, such as assessment of functional self-efficacy, have greater explanatory power than specific pain-related assessments [5][6][7][8][9]. In addition, associations were found between low self-efficacy and higher disability rates [7,10].…”