The Pain Self-Efficacy Questionnaire: Validation of an Abbreviated Two-Item Questionnaire

BackgroundThe Pain Self-Efficacy Questionnaire (PSEQ) is a validated tool to assess pain self-efficacy and is strongly correlated with disability. Reducing the number of questions of the original PSEQ to screen for self-efficacy will result in more efficient screening and less burden for the patient.ObjectiveThe aim of this study was to prospectively validate the shortened version of the PSEQ.MethodOverall, 249 new and follow-up patients visiting our outpatient orthopedic hand surgery clinic were prospectively enrolled and asked to complete the PSEQ, short version of the Disabilities of the Arm Shoulder and Hand, and 2-question version of the Patient Health Questionnaire (PHQ-2) depression questionnaires. The patients completed the questionnaires in the office and online 2 weeks after their visit. At the follow-up visit, the PSEQ was substituted with the 2-question version of the Pain Self-Efficacy Questionnaire (PSEQ-2). The factors associated with higher short forms of the Disabilities of the Arm, Shoulder and Hand scores were investigated in a bivariate and multivariable analysis. Paired t-test was used to compare the mean values of the short and long questionnaires at enrollment.ResultsThere was a large correlation (r = 0.90; p < 0.001) between the original PSEQ and the PSEQ-2 at enrollment. The Cronbach α were comparable for the PSEQ and the PSEQ-2 (α = 0.95 compared with α = 0.91). There was a small but statistically significant difference between the average scores of the PSEQ and PSEQ-2 (4.4 vs 4.8; p < 0.001). For the shortened PSEQ, a smaller—but still large—correlation was found with the short forms of the Disabilities of the Arm, Shoulder and Hand (r = 0.71 vs r = 0.61). Both the PSEQ-2 and the PSEQ were the most important predictors of the short forms of the Disabilities of the Arm, Shoulder and Hand scores. A substantial test-retest reliability was found for the PSEQ-2 (0.66).ConclusionThe PSEQ-2 can be used to quickly assess patients׳ pain self-efficacy.