Chronic pain costs the community an enormous amount and can be devastating for the individual. 

If we understand the factors that result in long term disability we are more likely to be able to help those with chronic pain. For their individual situation, their family, the workplace and the community.

“Self-efficacy” is the belief that you will cope with whatever life brings you. People with high self-efficacy tend to be confident, and tackle problems by thinking through the issues and working out solutions. They’re able to do so partly because they believe that they can.

People with poor self-efficacy, on the other hand, tend to be worriers. When presented with a problem they’re likely to become fearful that they won’t be able to cope, whether that problem is a dispute with a neighbour, a difficult issue at work, or the challenges of coping with an ongoing health issue such as chronic pain.

“Catastrophising” means making a problem bigger than it is. For example, somebody who catastrophises might hear that they have disc degeneration on their back scan and become very worried about their long term prospects.  They are more likely to believe that it is something serious and worrying, and this might lead them to reduce what they do both at home and at work.

Swedish researchers sought information from just over 430 patients with chronic pain. The patients answered a questionnaire and the researchers analysed the information, using the survey to assess depression, anxiety, and self-efficacy.

The researchers found that self-efficacy correlated with quality of life and general health.  People who had greater self-efficacy had better reported quality of life and had improved general health.

People with high self-efficacy also had less disability.

The results of this study are not unusual; there have been other similar studies that have shown similar results. 

The implication of this study is that it's worth assessing somebody’s self-efficacy. How do you do this? A specific questionnaire can be used - there are few available.

However it is fairly simple to listen to the individual. Do they sound confident? Do you think they can problem-solve? If you ask them if they are confident that they will manage, do they say yes?

On the other hand, are they using emotive language and sounding distressed?

If someone is struggling with low self efficacy, it may be appropriate to refer them to your organisation’s Employee Assistance Program (EAP) or some other form of support.

Authors
Borsbo B. Gerdle B. Peolsson M. .

Authors Full Name
Borsbo, Bjorn. Gerdle, Bjorn. Peolsson, Michael. .

Institution
Rehabilitation Medicine, Faculty of Health Sciences, Department of Clinical and Experimental Medicine, Linkoping, Sweden. bjorn.borsbo@liu.se

Title
Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health in with chronic pain patients.

Source
Disability & Rehabilitation. 32(17):1387-96, 2010.

Abstract
PURPOSE: To investigate the interactions between self-efficacy - including subcomponents - and symptoms (pain, depression and anxiety), catastrophising, disability, quality of life and health in a population of patients with chronic pain.

METHOD: The study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 patients with chronic whiplash-associated disorders and 236 patients with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological- and health-related variables.

RESULTS: In the multivariate context, depression, anxiety, catastrophising and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables - duration of pain, pain intensity and spreading of pain - formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophising and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life and health.

CONCLUSION: There is a complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

PubMed Link: http://www.ncbi.nlm.nih.gov/pubmed/20513205