Establishing cut-offs for the Pain Self-Efficacy Questionnaire for people living with chronic pain

LAY SUMMARY Cut-offs were established for the Pain Self-Efficacy Questionnaire (PSEQ) by examining it with other clinical measures in 189 patients, including 69 Veterans, who attended a four-week interdisciplinary chronic pain management program. By dividing the PSEQ scores into low, medium, and high ranges, the authors examined the PSEQ’s association with fear of movement/re-injury (kinesiophobia), pain interference, and pain catastrophizing at admission and discharge from the program. Kinesiophobia was found to be most related to the proposed cut-offs. Findings support the use of PSEQ cut-offs when considering self-efficacy and kinesiophobia. Future research should evaluate these cut-offs with larger samples and functional/occupational measures. The findings show promise for individuals with chronic pain and continue to increase the understanding of the clinicians who work with these individuals. Introduction: This study aimed to establish clinically informed sub-group cut-offs for the Pain Self-Efficacy Questionnaire (PSEQ) by examining correlations and main and interaction effects of the PSEQ with other clinical measures and demographic data in a sample of individuals who attended a four-week interdisciplinary chronic pain management program. Methods: A sample of 189 patients (69 of whom were referred by Veterans Affairs Canada) who attended a four-week interdisciplinary chronic pain management program completed several pain-related measures at admission and discharge, including the PSEQ, Tampa Scale for Kinesiophobia (TSK-11), Pain Catastrophizing Scale (PCS), and Pain Disability Index (PDI). These measures were used to examine the discriminant validity of the PSEQ after dividing the PSEQ scores into three categories (low, medium, and high) based on the standard deviation. Results: The PSEQ at admission was significantly and negatively associated with the TSK, PDI, and PCS admission and discharge scores. The PSEQ cut-offs significantly interacted with the PSEQ and TSK scores at admission and discharge. However, the PSEQ cut-offs did not interact with the PCS or PDI. Discussion: Findings support the use of PSEQ cut-offs when considering the PSEQ and the TSK, with a specific focus on Veterans. Replication of this study with larger samples and functional/occupational measures is recommended. The study also highlights that Veterans may have specific needs and challenges when dealing with chronic pain and this population should be considered in developing and implementing pain management strategies regarding their self-efficacy.