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Responsiveness and Minimal Important Change of the Pain Self-Efficacy Questionnaire and Short Forms in Patients With Chronic Low Back Pain

  • Alessandro Chiarotto
    Correspondence
    Address reprint requests to Alessandro Chiarotto, PT, MSc, Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, Vrije Universiteit Amsterdam, de Boelelaan 1085, room U-601, 1081 HV, Amsterdam, The Netherlands.
    Affiliations
    Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands

    Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands
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  • Carla Vanti
    Affiliations
    Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy
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  • Christine Cedraschi
    Affiliations
    Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland
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  • Silvano Ferrari
    Affiliations
    Department of Biomedical Sciences, University of Padova, Padova, Italy
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  • Fernanda de Lima e Sà Resende
    Affiliations
    Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy
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  • Raymond W. Ostelo
    Affiliations
    Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands

    Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands
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  • Paolo Pillastrini
    Affiliations
    Department of Biomedical and Neurological Sciences, University of Bologna, Bologna, Italy
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      Highlights

      • The PSEQ and its short forms are responsive in patients with chronic low back pain.
      • The 4-item PSEQ could be preferred over the original PSEQ in busy clinical settings.
      • The minimal important change of PSEQ and short forms depends on baseline values.

      Abstract

      The Pain Self-Efficacy Questionnaire (PSEQ) is a valid and reliable patient-reported instrument used to assess pain self-efficacy in patients with chronic low back pain (CLBP). Recently, the 2-item (PSEQ-2) and the 4-item (PSEQ-4) short versions were developed showing satisfactory measurement properties in mixed populations with chronic pain. The aim of this study was to examine responsiveness and minimal important change (MIC) of PSEQ, PSEQ-2, and PSEQ-4 in patients with CLBP. We used a sample of 104 patients undergoing multimodal physical therapy designed to partly change pain self-efficacy beliefs. Responsiveness was assessed by testing 16 a priori formulated hypotheses regarding effect sizes, areas under the curve, and correlations with changes in other instruments measuring other constructs. The MIC was calculated using an external anchor specific for pain self-efficacy and the receiver operator characteristic (ROC) method. The PSEQ and the PSEQ-4 met all hypotheses, whereas the PSEQ-2 met all but 1. The MICs were 5.5 for the PSEQ (9% of the scale range) and 1.5 for PSEQ-2 (13% scale range) and PSEQ-4 (6% scale range). MIC values were different for patients with low or high baseline values for all 3 instruments. The PSEQ and its short versions are adequately responsive instruments in patients with CLBP.

      Perspective

      This study suggests that the PSEQ and its short versions are responsive measures of pain self-efficacy in patients with CLBP, adding to previous literature on their validity and reliability. Considering their similar responsiveness, the 4-item PSEQ could replace the original 10-item version in busy clinical or research settings.

      Key words

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