Self-efficacy For Pain Management Research Articles

Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol.

BackgroundPersistent knee pain in people over 50 years of age is often attributable to knee osteoarthritis (OA), a common joint condition that causes physical and psychological dysfunction. Exercise and pain coping skills training (PCST) can help reduce the impact of persistent knee pain, however, access to health professionals who deliver these services can be challenging. With increasing access to the Internet, remotely delivered Internet-based treatment approaches may provide alternatives for healthcare delivery. This pragmatic randomised controlled trial will investigate whether an Internet-delivered intervention that combines PCST and physiotherapist-guided exercise (PCST + Ex) is more effective than online educational material (educational control) in people with persistent knee pain.Methods/DesignWe will recruit 148 people over 50 years of age with self-reported persistent knee pain consistent with knee OA from the Australian community. Following completion of baseline questionnaires, participants will be randomly allocated to access a 3-month intervention of either (i) online educational material, or (ii) the same online material plus an 8-module (once per week) Internet-based PCST program and seven Internet-delivered physiotherapy sessions with a home exercise programs to be performed 3 times per week. Outcomes will be measured at baseline, 3 months and 9 months with the primary time point at 3 months. Primary outcomes are average knee pain on walking (11-point numeric rating scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index subscale). Secondary outcomes include additional measures of knee pain, health-related quality-of-life, perceived global change in symptoms, and potential moderators and mediators of outcomes including self-efficacy for pain management and function, pain coping attempts and pain catastrophising. Other measures of adherence, adverse events, harms, use of health services/co-interventions, and process measures including appropriateness and satisfaction of the intervention, will be collected at 3, 6 and 9 months.DiscussionThe findings will help determine the effectiveness and acceptability of Internet access to a combination of interventions that are known to be beneficial to people with persistent knee pain. This study has the potential to guide clinical practice towards innovative modes of healthcare provision.Trial registrationAustralian New Zealand Clinical Trials Registry reference: ACTRN12614000243617.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-279) contains supplementary material, which is available to authorized users.

Implementation of Sustainable Evidence-Based Practice for the Assessment and Management of Pain in Residential Aged Care Facilities

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice.

The influence of personality on reported pain and self-efficacy for pain management in older cancer patients

This study examines the relationship of personality traits and affect on cancer-related pain in 150 older adults receiving outpatient treatment at a comprehensive cancer center. Regression analyses revealed extraversion as a significant predictor of current pain, with openness to experience as a significant indicator of average pain. Similarly, positive affect and negative affect were significant predictors of self-efficacy for pain management. Moderation models showed that conscientiousness and extraversion were significant moderators in the relationship between self-efficacy for pain management and worst pain. These findings suggest that different personality types may influence perceptions of pain severity.

The Acceptability of Acupuncture for Low Back Pain: A Qualitative Study of Patient’s Experiences Nested within a Randomised Controlled Trial

IntroductionThe National Institute for Health and Clinical Excellence guidelines recommend acupuncture as a clinically effective treatment for chronic back pain. However, there is insufficient knowledge of what factors contribute to patients’ positive and negative experiences of acupuncture, and how those factors interact in terms of the acceptability of treatment. This study used patient interviews following acupuncture treatment for back pain to identify, understand and describe the elements that contribute or detract from acceptability of treatment.MethodsThe study used semi-structured interviews. Twelve patients were interviewed using an interview schedule as a sub-study nested within a randomised controlled trial of acupuncture for chronic back pain. The interviews were analysed using thematic analysis.Results and DiscussionThree over-arching themes emerged from the analysis. The first entitled facilitators of acceptability contained five subthemes; experience of pain relief, improvements in physical activity, relaxation, psychological benefit, reduced reliance on medication. The second over-arching theme identified barriers to acceptability, which included needle-related discomfort and temporary worsening of symptoms, pressure to continue treatment and financial cost. The third over-arching theme comprised mediators of acceptability, which included pre-treatment mediators such as expectation and previous experience, and treatment-related mediators of time, therapeutic alliance, lifestyle advice and the patient’s active involvement in recovery. These themes inform our understanding of the acceptability of acupuncture to patients with low back pain.ConclusionThe acceptability of acupuncture treatment for low back pain is complex and multifaceted. The therapeutic relationship between the practitioner and patient emerged as a strong driver for acceptability, and as a useful vehicle to develop the patients’ self-efficacy in pain management in the longer term. Unpleasant treatment related effects do not necessarily detract from patients’ overall perception of acceptability.

Evaluation of a multi-component group exercise program for adults with arthritis: Fitness and Exercise for People with Arthritis (FEPA)

BackgroundResearch supports the favorable effects of exercise on physical and psychosocial outcomes in those with arthritis. Few easily disseminated, multi-component, arthritis-specific programs have been evaluated using both physical function and psychosocial measures. Fitness and Exercise for People with Arthritis (FEPA) is a new community-based, 3-month, instructor supervised multi-component exercise program for individuals with arthritis designed to increase strength, flexibility, balance, and aerobic conditioning, while emphasizing joint-protection and proper biomechanics. PurposeTo conduct a preliminary evaluation of the effects of the FEPA program on physical function and arthritis-related outcomes in individuals with arthritis. MethodMiddle-aged (n = 31, Mage = 54.8 ± 7.2) and older (n = 79, Mage = 76.0 ± 6.6) adults with arthritis completed the instructor led FEPA program in community senior centers, churches, and adult education settings. Changes in physical function, measured using the arm curl, back-scratch test, 8-foot up-and-go, and 6 min walk and self-reported arthritis-related pain, perceived physical function, affect, and self-efficacy for symptom management were assessed using RM ANOVA. ResultsSignificant improvements (ps < .05) in all physical function measures were found in the older group. In the middle-aged group, significant improvements (ps < .05) were found in the 8-foot up-and-go and 6 min walk. Self-reported physical function, pain perceptions, and self-efficacy for pain management significantly improved (ps < .05) in middle-aged participants, while only self-reported pain perceptions significantly improved in the older group. ConclusionsFEPA shows promise for improving health-related outcomes in those with arthritis, and has potential for sustainability in community settings.

NUMERICAL MODELLING OF THE ABDOMINAL WALL APPLIED TO HERNIA SURGERY

Research supports the favorable effects of exercise on physical and psychosocial outcomes in those with arthritis. Few easily disseminated, multi-component, arthritis-specific programs have been evaluated using both physical function and psychosocial measures. Fitness and Exercise for People with Arthritis (FEPA) is a new community-based, 3-month, instructor supervised multi-component exercise program for individuals with arthritis designed to increase strength, flexibility, balance, and aerobic conditioning, while emphasizing joint-protection and proper biomechanics.To conduct a preliminary evaluation of the effects of the FEPA program on physical function and arthritis-related outcomes in individuals with arthritis.Middle-aged (n = 31, Mage = 54.8 ± 7.2) and older (n = 79, Mage = 76.0 ± 6.6) adults with arthritis completed the instructor led FEPA program in community senior centers, churches, and adult education settings. Changes in physical function, measured using the arm curl, back-scratch test, 8-foot up-and-go, and 6 min walk and self-reported arthritis-related pain, perceived physical function, affect, and self-efficacy for symptom management were assessed using RM ANOVA.Significant improvements (ps < .05) in all physical function measures were found in the older group. In the middle-aged group, significant improvements (ps < .05) were found in the 8-foot up-and-go and 6 min walk. Self-reported physical function, pain perceptions, and self-efficacy for pain management significantly improved (ps < .05) in middle-aged participants, while only self-reported pain perceptions significantly improved in the older group.FEPA shows promise for improving health-related outcomes in those with arthritis, and has potential for sustainability in community settings.

Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study

To describe the methodology of the first NIH-funded clinical trial for seniors with comorbid depression and chronic low back pain. Randomized controlled effectiveness trial using stepped care methodology. Participants are ≥60 years old. Phase 1 (6 weeks) is open treatment with venlafaxine xr 150 mg/day and supportive management (SM). Response is 2 weeks of PHQ-9 ≤5 and at least 30% improvement in the average numeric rating scale for pain. Nonresponders progress to phase 2 (14 weeks) in which they are randomized to high-dose venlafaxine xr (up to 300 mg/day) with problem solving therapy for depression and pain (PST-DP) or high-dose venlafaxine xr and continued SM. Primary outcomes are the univariate pain and depression response and both observed and self-reported disability. Survival analytic techniques will be used, and the clinical effect size will be estimated with the number needed to treat. We hypothesize that self-efficacy for pain management will mediate response for subjects randomized to venlafaxine xr and PST-DP. Not applicable. The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.

Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open‐label pilot study

In older adults, major depressive disorder (MDD) and chronic low back pain (CLBP) are common and mutually exacerbating. We predicted that duloxetine pharmacotherapy and Depression and Pain Care Management (DPCM) would result in (1) significant improvement in MDD and CLBP and (2) significant improvements in health-related quality of life, anxiety, disability, self-efficacy, and sleep quality. Twelve week open-label study using duloxetine up to 120 mg/day + DPCM. Outpatient late-life depression research clinic. Thirty community-dwelling adults >60 years old. Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF). 46.7% (n = 14) of the sample had a depression remission. All subjects who met criteria for the depression remission also had a pain response. 93.3% (n = 28) had a significant pain response. Of the subjects who met criteria for a low back pain response, 50% (n = 14) also met criteria for the depression remission. The mean time to depression remission was 7.6 (SE = 0.6) weeks. The mean time to pain response was 2.8 (SE = 0.5) weeks. There were significant improvements in mental health-related quality of life, anxiety, sleep quality, somatic complaints, and both self-efficacy for pain management and for coping with symptoms. Physical health-related quality of life, back pain-related disability, and self-efficacy for physical functioning did not improve. Serotonin and norepinephrine reuptake inhibitors like duloxetine delivered with DPCM may be a good choice to treat these linked conditions in older adults. Treatments that target low self-efficacy for physical function and improving disability may further increase response rates.

Demographic, Clinical, and Pain Characteristics Are Associated With Average Pain Severity Groups in a Sample of Oncology Outpatients

Cut-points (CP) for pain severity are useful because they may help clinicians to identify patients with clinically significant pain. However, a need exists to evaluate whether different pain severity groups differ on selected demographic, clinical, and pain characteristics, as well as on factors that may be amenable to psychoeducational interventions such as self-efficacy for pain management, coping strategies, and barriers to pain management. In this cross-sectional study of 210 oncology outpatients with pain, an optimal CP of 4 was found using ratings of average pain intensity. The variables that provided a unique contribution to the prediction of membership in the >4 CP group were gender, presence of breakthrough pain, comorbidities, barriers to pain management, and total self-efficacy for pain management. In addition, patients in the >4 CP group reported lower scores on physical, role, cognitive, and global health function. An average pain CP of >4 could be used to screen oncology outpatients with clinically significant pain. Clinicians must consider a number of demographic, clinical, and pain characteristics as part of their pain assessment procedures. The effectiveness of psychoeducational interventions aimed at barriers and patients self-efficacy for pain management need to be tested.

(316) Psychological and physiological correlates of a brief intervention to enhance self-regulation in chronic pain

The main objectives of this ongoing study are to determine if training and practice in a brief focused breathing technique is associated with: 1) increased self-regulatory ability to a standard laboratory stressor (cold pressor test) as indexed by Heart Rate Variability; 2) increased pain tolerance to a cold pressor test; 3) decreased breathing rate at follow-up; 4) increased pain management self-efficacy; and 5) decreased self-reported fatigue. Participants were diagnosed with either fibromyalgia (n=13) or masticatory myofascial pain (n=7). Study participants completed an initial laboratory assessment including a diaphragmatic breathing training session. Participants were instructed to practice the technique for three ten-minute sessions each day, and returned to the lab for a second visit after two-weeks. Preliminary results from this study indicate significant improvements in fatigue (p<.01) and pain management self-efficacy (p<.01) between pre and post-training assessments. More striking is the change in pain severity. Mean pain severity scores changed from 4.56 to 3.78 (p<.05) on a 0-10 Visual Analog Scale with 10 being the worst. Tolerance to the cold pressor test increased significantly (60.3s to 76.8s, p<.01). Total power in the HRV spectral frequency range post cold-pressor increased significantly between the two lab sessions (p’s<.05). Additionally, and as expected, breathing rate was significantly reduced at the second assessment. Results of this preliminary study suggest training and practice of a brief diaphragmatic breathing technique is associated with significant changes in a number of areas of physiological and psychological functioning in chronic pain patients. In particular, HRV total power post-training may represent a significant improvement in self-regulatory ability. Further, the significant reduction in pain severity between time one and time two suggests regular use of a self-regulatory training technique may be associated with a reduction in subjective pain measures.

Physical and Psychological Correlates of Disability among a Cohort of Individuals with Knee Osteoarthritis

While the physical correlates of knee osteoarthritis are well documented, less well documented are aspects of psychological functioning that may affect overall health and functional status. This paper describes the findings of a cross-sectional analysis that examined the strength of the relationship between selected psychological factors and the walking ability of adults with knee joint osteoarthritis. The variables assessed were pain, depression, levels of self-efficacy for pain and other-symptoms management, walking endurance, walking speed, and perceived exertion when walking. The sample, including 57 persons with unilateral and 43 persons with bilateral radiographic and symptomatic knee osteoarthritis, mean age, 69.9 +/- 1 years, underwent standard assessment procedures on a single test occasion using several validated questionnaires and a series of walking tests on level ground. Bivariate and multiple regression analyses revealed that (a) higher pain and other-symptoms self-efficacy scores were associated with lower levels of pain ( r = -0.29, -0.20.), perceived exertion during a walking task ( r = -0.29, -0.31), and depression scores ( r = -0.46, -0.54) ( p < 0.001); (b) subjects with higher levels of self-efficacy for managing symptoms other than pain also recorded faster and fast speed walking velocities than those with lower self-efficacy scores ( r = 0.30, 0.31) ( p < 0.001); (c) self-efficacy for pain was the strongest predictor of pain intensity, and self-efficacy for symptom management was the strongest predictor of perceived exertion during walking, depression, and pain self-efficacy. Although no cause-effect relationship can be deduced from a cross-sectional analysis, these data imply that efforts to heighten self-efficacy for pain and other-symptoms management may influence the affective status, function, and effort-related perceptions of people with knee osteoarthritis quite significantly.

Long-Term Impact of Fit and Strong! on Older Adults With Osteoarthritis

We present final outcomes from the multiple-component Fit and Strong! intervention for older adults with lower extremity osteoarthritis. A randomized controlled trial compared the effects of this exercise and behavior-change program followed by home-based reinforcement (n=115) with a wait list control (n=100) at 2, 6, and 12 months. Fit and Strong! combined flexibility, aerobic walking, and resistance training with education and group problem solving to enhance self-efficacy for exercise and maintenance of physical activity. All participants developed individualized plans for long-term maintenance. Relative to controls, treatment participants experienced statistically significant improvements in self-efficacy for exercise (p=.001), minutes of exercise per week (p=.000), and lower extremity stiffness (p=.018) at 2 months. These benefits were maintained at 6 months and were accompanied by increased self-efficacy for adherence to exercise over time (p=.001), reduced pain (p=.040), and a marginally significant increase in self-efficacy for arthritis pain management (p=.052). Despite a substantially smaller sample size at 12 months, significant treatment-group effects were maintained on self-efficacy for exercise (p=.006) and minutes of exercise per week (p=.001), accompanied by marginally significant reductions in lower extremity stiffness (p=.056) and pain (p=.066). No adverse health effects were seen. Effect sizes for self-efficacy for exercise and for maintenance of physical activity were 0.798 and 0.713, and 0.905 and 0.669, respectively, in the treatment group at 6 and 12 months. This consistent pattern of benefits indicates that this low-cost intervention is efficacious for older adults with lower extremity osteoarthritis.

Student Nurses' Knowledge, Attitudes, and Self-Efficacy of Children's Pain Management: Evaluation of an Education Program in Taiwan

The purpose of this study was to examine the effectiveness of a pediatric pain education program (PPEP) for student nurses. The sample consisted of 181 licensed student nurses who were enrolled in a nursing school in Taiwan. Student nurses attended a 4-hour PPEP that involved case scenario discussion, video, and lecture. Data were collected by an extensive questionnaire that assessed student nurses' knowledge of, attitudes toward, and self-efficacy in pediatric pain assessment and pharmacological and nonpharmacological pain management. The results demonstrated that student nurses gained significant knowledge of pediatric pain, expressed more appropriate attitudes, and reported greater self-efficacy in children's pain management after attending PPEP. Their knowledge of analgesic pharmacotherapy did not significantly improve. These results suggest that PPEP should be integrated into pediatric nursing curricula to enhance knowledge and skills regarding children's pain management during the early stage of a nursing career.

(942): Chronic illness and pain problems related to self efficacy in pain management and rehabilitation

A recent study performed at the University of Utah Medical School compared a measure of self-efficacy being developed and provisionally described as the “Automatic Thoughts Inventory” (ATI) with a well validated instrument describing the range and impact of problems related to the course of chronic illness and pain, the Chronic Illness Problem Inventory (CIPI) in a sample of 70 patients. Discrete CIPI problem areas of: sleeping, eating, finances/employment, medication use, interaction with medical staff, focus on personal illness, cognitive functioning, physical appearance, bodily deterioration, inactivity, social activity, family/friends and assertion were associated with summary items from the ATI of: affirmation of life/coping, finality/coming to terms, life satisfaction, sense of well-being and belief in/access to meaning using Structural Equation Modeling analysis and the program Analysis of Moment Structures (AMOS 4). The model converged successfully (CFI= .98, RMSEA= .06), describing dynamic relationships between CIPI problem areas and self-efficacy factors from the ATI. This pilot study revealed important impacts of self-efficacy on patient ADLs and social functioning, and indicated the important relationships between factors comprising the two instruments. Clinical implications and the relationships of factors with demographic variables and pain and symptom measures are discussed.

(880): Self-efficacy for pain and weight management among overweight patients with osteoarthritis: Relationship to pain, physical disability, and psychological distress

(880): Self-efficacy for pain and weight management among overweight patients with osteoarthritis: Relationship to pain, physical disability, and psychological distress

Effect Of Tai Chi On Pain Self-efficacy Related To Knee Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis in the United States and causes functional limitations and pain that worsen an individual's quality of life. While reducing the pain associated with OA is an important consideration in managing OA, understanding the effect of the treatment on an individual's self-efficacy to deal with the pain is also a consideration. PURPOSE To examine the effectiveness of a 6-week Tai Chi intervention on improving self-efficacy for dealing with the pain associated with OA. METHODS Female participants (n = 34, 63.4±7.8 yr) were recruited through community announcements and screened based on clinical criteria. All participants were enrolled in a 6-week Tai Chi intervention program (1 hr/session, 2×/wk). Self-efficacy measurements were assessed at the beginning (a), 3-weeks (b), and the end (c) of the intervention using the Chronic Pain Self-Efficacy Scale (CPSS). The CPSS has three categories; self-efficacy for pain management (pse), self-efficacy for physical function (fse), and self-efficacy for coping with symptoms (cse). Time effects were assessed with repeated measures ANOVA. RESULTS Means±SD for the three measures at the three time points were as follows; pse: a= 72.4±21.7, b = 71.7±21.9, c = 76.9±23.5, fse: a = 78.1±21.5, b = 82.8±21.5, c = 84.5±23.1, cse: a = 73.9±18.9, b = 76.5± 19.5, c = 78.5±20.9. The analysis revealed no significant time effects on any of the self-efficacy measures: pse(2, 74) F = .83, p = .44, η =.03; fse(2, 74) F = 1.21, p = .30, η = .04; cse(2, 74) F = .73, p = .48, η =.02. CONCLUSION Self-efficacy scores tended to increase during the intervention; however, the magnitude of these changes was not statistically significant. It is possible that a short-term 6-week Tai Chi training program is not sufficient to improve self-efficacy. Additionally, the participants were functioning at a high level and possessed a high level of pain self-efficacy at the beginning of the intervention which may have led to a ceiling effect in improvement. Future investigations should examine participants with moderate or severe OA symptoms having more functional deficits and lower self-efficacy in a long-term intervention.

Social support in women with fibromyalgia: Is quality more important than quantity?

AbstractThe present study is an examination of the effects of quality and quantity of social support on the psychological and physical well‐being of women with fibromyalgia syndrome (FMS). Participants were 568 women who were members of a health maintenance organization (HMO) with a confirmed diagnosis of FMS. Participants were administered a battery of questionnaires assessing their psychological and physical well‐being. Measures of depression, self‐efficacy, helplessness, mood disturbance, health status, impact of FMS, and social support were included. Regression analyses indicated that larger social support networks were associated with greater levels of self‐efficacy for pain and symptom management, while the perceived quality of social support was associated with lower levels of depression, helplessness, mood disturbance, impact of FMS, higher levels of self‐efficacy for function and symptom management, as well as overall psychological well‐being. These findings indicate that the quality of social support is more important than quantity in determining outcomes in women with FMS. Thus, the quality of social support has important financial and psychosocial implications for the individual and for the community as a whole. Future research should examine longitudinal changes in quality of social support and the corresponding changes in health status and psychological well‐being, as well as the effects of integrating manipulations designed to affect the quality of social support into community interventions designed to enhance the well‐being of women with FMS. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 425–438, 2004.

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain

The present study describes the development of the Chronic Pain Self-Efficacy Scale (CPSS), a 22-item questionnaire designed to measure chronic pain patients' perceived self-efficacy to cope with the consequences of chronic pain. The CPSS and other measures of psychosocial functioning were administered to 141 consecutive patients who were referred to an outpatient multidisciplinary pain treatment program. An exploratory factor analysis of the CPSS responses identified 3 factors: self-efficacy for pain management (PSE), self-efficacy for coping with symptoms (CSE), and self-efficacy for physical function (FSE). The CPSS then was administered to a replication sample of 136 chronic pain patients. Factor analysis confirmed the 3-factor structure of the CPSS. The subscale scores derived from the factor analysis were significantly correlated with measures of depression, hopelessness, somatic preoccupation, and adaptation to the chronic pain experience. Multiple regression analyses provided further support for the concurrent and construct validity of the CPSS. The scale may aid in the evaluation of the self-efficacy beliefs of chronic pain patients.

Correlations between attentional tests and CNV-parameters

Patient reported outcomes (PROs) are increasingly being implemented into the care of patients with cancer. The use of a standard set of PROs (e.g., pain) in cancer is becoming established and there is interest in what additional PROs might provide valuable information. The goal of this observational study was to examine how the PROs of self-efficacy for pain and other symptoms assessed at the point of service were associated with pain, symptom severity and distress, and physical and psychosocial functioning in a sample of breast and gastrointestinal patients. We also sought to examine differences in these relationships by cancer type (breast and gastrointestinal) as well as understand differences in self-assessment mode (paper/pencil or electronic tablet).178 patients with breast (n = 65) and gastrointestinal cancer (n = 113) completed the Chronic Pain Self Efficacy Scale, M.D. Anderson Symptom Inventory, and Functional Assessment of Cancer Therapy – General questionnaires. Measures were completed with paper and pencil and electronically using a tablet computer while patients waited for their clinical appointment. Responses from the initial completed questionnaires on both the paper and electronic instruments were analyzed.Patients’ self-efficacy scores for pain and other symptoms correlated positively with pain, symptom severity and distress, and physical and psychosocial functioning; patients with lower levels of self-efficacy reported poorer outcomes and functioning overall. The results were independent of cancer type and mode of assessment. No statistically significant differences were found in the PROs when collected by electronic technology versus paper-pencil mode; patients were very satisfied with using the tablet computer to complete the PRO measures.Our results suggest that self-efficacy for pain and symptom management may be a beneficial addition to clinic-based PRO assessment batteries for patients with cancer and other chronic diseases. Existing short, validated symptom self-efficacy scales could easily be integrated into clinical practice to help healthcare providers identify patients that might benefit from intervention. Study results also support existing research that suggests electronic approaches are a practical way to collect PRO data, including self-efficacy data, in the clinic. Overall, our data suggest that patients who have particularly low levels of self-efficacy for pain and symptom management may be at risk for higher levels of pain and disability. Thus, if self-efficacy for pain and symptom management were routinely collected at the time of clinical service, psychosocial interventions to improve self-efficacy for pain and symptom management, and in turn overall quality of life, could be implemented in a timely fashion.