Development and Validation of the French-Canadian Chronic Pain Self-Efficacy Scale

BACKGROUND: Perceived self-efficacy is a non-negligible outcome when measuring the impact of self-management interventions for chronic pain patients. However, no validated, chronic pain-specific self-efficacy scales exist for studies conducted with French-speaking populations. OBJECTIVES: To establish the validity of the use of the French-Canadian Chronic Pain Self-efficacy Scale (FC-CPSES) among chronic pain patients.METHODS: The Chronic Disease Self-Efficacy Scale is a validated 33-item self-administered questionnaire that measures perceived self-efficacy to perform self-management behaviours, manage chronic disease in general and achieve outcomes (a six-item version is also available). This scale was adapted to the context of chronic pain patients following cross-cultural adaptation guidelines. The FC-CPSES was administered to 109 fibromyalgia and 34 chronic low back pain patients (n=143) who participated in an evidence-based self-management intervention (the PASSAGE program) offered in 10 health care centres across the province of Quebec. Cronbach’s alpha coefficients (α) were calculated to determine the internal consistency of the 33- and six-item versions of the FC-CPSES. With regard to convergent construct validity, the association between the FC-CPSES baseline scores and related clinical outcomes was examined. With regard to the scale’s sensitivity to change, pre- and postintervention FC-CPSES scores were compared. RESULTS: Internal consistency was high for both versions of the FC-CPSES (α=0.86 to α=0.96). Higher self-efficacy was significantly associated with higher mental health-related quality of life and lower pain intensity and catastrophizing (P<0.05), supporting convergent validity of the scale. There was a statistically significant increase in FC-CPSES scores between pre- and postintervention measures for both versions of the FC-CPSES (P<0.003), which supports their sensitivity to clinical change during an intervention. CONCLUSIONS: These data suggest that both versions of the FC-CPSES are reliable and valid for the measurement of pain management self-efficacy among chronic pain patients

Multicomponent Interdisciplinary Group Intervention for Self-Management of Fibromyalgia: A Mixed-Methods Randomized Controlled Trial

<div><p>Background</p><p>This study evaluated the efficacy of the PASSAGE Program, a structured multicomponent interdisciplinary group intervention for the self-management of FMS.</p><p>Methods</p><p>A mixed-methods randomized controlled trial (intervention (INT) vs. waitlist (WL)) was conducted with patients suffering from FMS. Data were collected at baseline (T₀), at the end of the intervention (T₁), and 3 months later (T₂). The primary outcome was change in pain intensity (0-10). Secondary outcomes were fibromyalgia severity, pain interference, sleep quality, pain coping strategies, depression, health-related quality of life, patient global impression of change (PGIC), and perceived pain relief. Qualitative group interviews with a subset of patients were also conducted. Complete data from T₀to T₂were available for 43 patients.</p><p>Results</p><p>The intervention had a statistically significant impact on the three PGIC measures. At the end of the PASSAGE Program, the percentages of patients who perceived overall improvement in their pain levels, functioning and quality of life were significantly higher in the INT Group (73%, 55%, 77% respectively) than in the WL Group (8%, 12%, 20%). The same differences were observed 3 months post-intervention (Intervention group: 62%, 43%, 38% vs Waitlist Group: 13%, 13%, 9%). The proportion of patients who reported ≥50% pain relief was also significantly higher in the INT Group at the end of the intervention (36% vs 12%) and 3 months post-intervention (33% vs 4%). Results of the qualitative analysis were in line with the quantitative findings regarding the efficacy of the intervention. The improvement, however, was not reflected in the primary outcome and other secondary outcome measures.</p><p>Conclusion</p><p>The PASSAGE Program was effective in helping FMS patients gain a sense of control over their symptoms. We suggest including PGIC in future clinical trials on FMS as they appear to capture important aspects of the patients’ experience.</p><p>Trial registration</p><p>International Standard Randomized Controlled Trial Number Register <a href="http://www.controlled-trials.com/ISRCTN14526380" target="_blank">ISRCTN14526380</a></p></div

Summary of the components and content of the PASSAGE Program.

<p>Summary of the components and content of the PASSAGE Program.</p

Mean scores and their Standard Errors in the Intervention Group at baseline (T0), at the end of the intervention (T1), and at 3, 6, and 12 months thereafter (T2, T3, T4).

<p>NRS = Numerical Rating Scale (higher scores indicate greater pain intensity); FIQ = Fibromyalgia Impact Questionnaire (higher scores indicate greater FMS severity); CSQ = Coping Strategies Questionnaire (higher scores indicate greater use of the strategy/coping efforts); PCS = Pain Catastrophizing Scale (higher scores reflect greater pain catastrophizing).</p

Percentage of patients in the Intervention and Waitlist Groups who reported that their pain, functioning and quality of life improved (slightly, greatly, or considerably) at T1 compared to baseline (T0) on the Patient Global Impression of Change Scales.

<p>Percentage of patients in the Intervention and Waitlist Groups who reported that their pain, functioning and quality of life improved (slightly, greatly, or considerably) at T1 compared to baseline (T0) on the Patient Global Impression of Change Scales.</p

Timeline of data collection in each study group.

<p>Timeline of data collection in each study group.</p

Magnitude and significance of the improvements in the intervention (INT, n = 28) and the waitlist (WL, n = 29) groups up to three months post-intervention.

<p>Magnitude and significance of the improvements in the intervention (INT, n = 28) and the waitlist (WL, n = 29) groups up to three months post-intervention.</p