The factors driving self-efficacy in intractable chronic pain patients: a retrospective study

Abstract

BackgroundThe fear-avoidance model is a theoretical paradigm for explaining acute and chronic pain. In this model, pain catastrophizing plays an important role. On the other hand, self-efficacy influences whether patients view their pain optimistically, ultimately preventing the conversion of pain into intractable pain. The aim of the present study was to evaluate the factors that influence self-efficacy in patients with chronic pain.MethodsStudy participants included 147 outpatients (35 men, 112 women) with intractable chronic pain who visited our hospital between September 2014 and July 2015. Their mean age was 71.0 (range 32–92) years. Pain sites were as follows: low back, 97 patients; knee, 71 patients; shoulder, 34 patients; and hip, 15 patients. All patients were assessed using the following measures: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). All participants were further divided into two groups based on median PSEQ scores (group L: PSEQ of 35 points or less, n = 74; group H: PSEQ greater than 35 points, n = 73). The factors that influenced self-efficacy in these patients were analyzed using univariate and multiple linear regression analyses.ResultsSignificant differences were observed in gender; pain duration; and NRS, PDAS, HADS, and PCS scores between group L and group H. Multiple linear regression analysis revealed that self-efficacy was correlated with PDAS score, HADS depression score, and pain duration.ConclusionsPatients with longer pain duration indicated greater self-efficacy and patients with higher pain disability and depression exhibited lower self-efficacy.

The relationship between symptom severity, bother and psychological factors in women with pelvic organ prolapse: A cross‐sectional observational study

“…This may have been due to the fact that 63.2% of the women in our study were already engaged in treatment for POP and so were not a naive sample, having already been exposed to strategies to improve their self‐efficacy 46 . Catastrophizing and poor self‐efficacy can exist independently of each other, which may explain the difference in the strength of the relationship of catastrophizing and self‐efficacy as predictors of bother 47 . Self‐efficacy strongly underpins motivation to adhere to pelvic floor training programs 46 so screening for, and implementation of specific strategies to improve low self‐efficacy, may ultimately improve outcomes of conservative management.…”

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A 12-hour rapid titration method for cancer pain: a randomized, controlled, open-label study

“…Previous studies have shown that the standard analgesic titration protocols using oxycodone or morphine showed no significant difference in analgesic effects (9,22,23). However, another randomized controlled study showed that oxycodone sustained-release tablets had a superior time-to-analgesia onset compared to immediaterelease morphine, which helped to reduce titration (25,26). In our current study, the proportion of multiple BTP episodes was significantly lower in the oxycodone group than in the morphine group, which might be explained by the higher proportion of decreased NRS score in the oxycodone group.…”

“…In our current study, the proportion of multiple BTP episodes was significantly lower in the oxycodone group than in the morphine group, which might be explained by the higher proportion of decreased NRS score in the oxycodone group. Since early analgesia may increase the patient's pain threshold and thus reduce the patient's pain perception, it may achieve better pain relief and improve the patient's quality of life (25,26). In our current study, the ESAS score, which reflects the quality of life, was significantly lower in the oxycodone group than in the morphine group at the 24th hour (P=0.047), and the decrease of ESAS score was significantly larger in the oxycodone group (P<0.001), suggesting the oxycodone group had higher quality of life than the morphine group.…”