Self‐efficacy in patients with chronic musculoskeletal conditions discharged from physical therapy service: A cross‐sectional study

Abstract

Objectives This study aimed to investigate self‐efficacy levels of patients after finishing rehabilitation for chronic musculoskeletal conditions and identify factors related to self‐efficacy. Method Two hundred and eight patients aged >40 years with musculoskeletal disorders were included. Self‐efficacy was assessed by the Chronic Pain Self‐Efficacy Scale (CPSS), and regression analyses were used to test six predictors of self‐efficacy: age, symptom duration, number of physical therapy sessions, postdischarge pain intensity, perceived clinical improvement, and cognitive reassurance. Self‐efficacy was compared between patients who reported improvement and worsening of their clinical condition, and a cutoff value for self‐efficacy was established using receiver operating characteristic curve analyses to distinguish patients with severe pain from those with mild to moderate pain. Results Better perceived clinical improvement (Beta = −0.37, p = 0.000), lower pain intensity (Beta = −0.33, p = 0.000), and a lower number of physical therapy sessions (Beta = −0.12, p = 0.027) were related to greater self‐efficacy. No significant associations were observed between self‐efficacy and age, symptom duration, and cognitive reassurance. The patients who reported improvement had greater self‐efficacy (204.76 ± 52.80) than those who reported worsening of their clinical condition (145.45 ± 44.18; p = 0.000). A CPSS score of 172 points (sensitivity of 0.77; specificity of 0.72) may indicate low self‐efficacy. Conclusion A higher perception of self‐efficacy after discharge from physiotherapy is associated with better perceived clinical improvement, lower pain intensity, and a lower number of physical therapy sessions. Therefore, interventions to support patients' exercise‐based rehabilitation should include self‐efficacy, which may affect the prognosis of patients with chronic conditions.

Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial

“…Some aspects likely contributed to the responsiveness of our patients to the exercise program, such as baseline moderate pain and self-efficacy greater than 172 points in the Chronic Pain Self-Efficacy Scale, which is the cut-off point used to identify low self-efficacy. 26 This concurs with evidence that the best results in shoulder function over time are associated with greater self-efficacy, less pain and baseline disability and the patient's expectation of a recovery. 27 On the other hand, if additional pain mechanics were present or overlapping or if any other uncontrolled psychosocial factors were present, this did not negatively influence the results.…”

“…Self-efficacy is associated with adherence to homebased exercises 29 and a higher perception of selfefficacy after discharge from physiotherapy is associated with better perceived clinical improvement, lower pain intensity and a lower number of physical therapy sessions. 26 The present study has some weakness, such as the absence of follow-up data to investigate the medium-and long-term effects of our intervention program and the relatively small number of patients. Moreover, it is important to emphasize that our results can be overestimated because the control group received minimal intervention compared to the intervention group, so the clinical relevance of these findings requires cautious interpretation.…”

O escore SPADI, idade, nível de escolaridade e gênero são preditivos de autoeficácia em pacientes com dor no ombro?

“…A versão brasileira apresenta consistência interna (α=0,94) excelente da pontuação total 19 . Pacientes com dor musculoesquelética que obtiveram pontuação nesse questionário de 172 ou menos foram classificados com baixa autoeficácia e aqueles que pontuaram acima de 172 pontos alta autoeficácia 15 .…”

“…As percepções de autoeficácia podem ser modificadas com intervenções específicas e podem contribuir para a melhoria da disfunção e de sintomas depressivos, e para adesão ao tratamento e tolerância à dor 14 . O nível de autoeficácia de pacientes com dor musculoesquelética crônica no momento da alta da fisioterapia também apresenta relação com uma maior percepção clínica de melhora, menor intensidade de dor e menor número de sessões de fisioterapia 15 . Portanto, é importante que o clínico inclua o nível de autoeficácia referente à dor crônica na avaliação inicial do paciente, e estratégias para aumentar a autoeficácia devem ser consideradas um alvo de intervenção 8 , o que engloba geralmente uma relação terapeuta-paciente que visa mudar as percepções e crenças do paciente por meio da educação, promovendo o automanejo da dor 16 .…”

Prospective, Single-blind, Randomized Controlled Trial to Evaluate the Effectiveness of a Digital Exercise Therapy Application Compared With Conventional Physical Therapy for the Treatment of Nonoperative Knee Conditions

“…Programs that promote self-management and self-efficacy can provide longer-term improvement in outcomes of musculoskeletal patients treated with PT. 16 It is possible that an interactive, mobile-based application could help individuals manage their condition from home and improve pain and functional outcomes.…”