Effects of a pain management programme on occupational performance are influenced by gains in self-efficacy

Abstract

Introduction The perceived capacity to perform particular activities or skills (i.e. self-efficacy) is paramount in occupational therapy and is thought to be reinforced by actual functional capacity. This study examined whether changes in self-efficacy or confidence to lift weighted items influences changes in occupational performance and disability levels in patients attending a cognitive behavioural therapy pain management programme. Method Clients attending an 8-week cognitive behavioural therapy pain management programme ( N = 125) completed questionnaires before treatment, at discharge, and at 3-month and 6-month reviews, including measures of pain self-efficacy, disability and self-perceived performance and satisfaction using the Canadian occupational performance measure. Analyses examined disability and occupational performance over time, adjusting for baseline characteristics (age, sex, education), and sought to determine whether self-efficacy or lifting confidence influenced the outcomes. Results The level of disability, lifting confidence, self-efficacy and occupational performance all improved over time; however, only occupational performance and lifting confidence maintained improvements up to the 6-month review. Self-efficacy had a greater impact on occupational performance than lifting confidence.

Economic analysis of patient-related effects of an interdisciplinary pain self-management program

“…Previous studies suggest that pain self-efficacy is positively associated with adjustment to a persistent pain condition. 27 , 53 Improvements in pain self-efficacy after an intervention are expected to be reflected in reductions of pain-related disability. 1 , 15 , 18 , 53 A study by Thomas et al indicated that the effects of a pain management program on occupational performance were influenced by gains in skills and confidence, including self-efficacy.…”

“… 27 , 53 Improvements in pain self-efficacy after an intervention are expected to be reflected in reductions of pain-related disability. 1 , 15 , 18 , 53 A study by Thomas et al indicated that the effects of a pain management program on occupational performance were influenced by gains in skills and confidence, including self-efficacy. 53 Pain self-efficacy beliefs (ie, confidence to function despite pain) have a stronger association with disability, pain behavior, and confidence to perform at work than with pain intensity.…”

“…Self-efficacy beliefs have a strong association with individual's capacity to work. 2 , 32 , 53 The 10-item PSEQ was used to measure patients' confidence performing day-to-day activities despite pain including household chores, paid and unpaid work, ability to enjoy leisure time, and their ability to cope without medication. At least 9 of 10 items must be complete for the PSEQ total to be valid.…”

A registry-based observational cohort study examining patterns of pain and mental health symptoms and their impact on work or other activities after injury.

“…Many patients seeking treatment for pain or mental health symptoms do so because they have persistent symptoms that are distressing or disruptive, and principally seek to reduce or ameliorate those symptoms (e.g., consistent with the precontemplation or contemplation stages of change with persistent focus on a medical cure; Gersh et al., 2011). We recognize, however, that the most effective rehabilitation psychology approaches focus on enhancing function and reducing disability (Thomas et al., 2021), and not symptom resolution per se. The present study focused on identifying patterns and predictors of reductions in both symptoms and their impacts on functioning over time.…”

Feasibility assessment of an occupational therapy lifestyle intervention added to multidisciplinary chronic pain treatment at a Danish pain centre: a qualitative evaluation from the perspectives of patients and clinicians

“…Occupational therapy assessments applied in the REVEAL(OT) could deliver information helpful to the other healthcare disciplines at the MPC such as weekly activity schedules or clinical reports on working with occupational goals. If occupational therapy became an integrated part of usual care, occupational therapists could assist in measuring and evaluating the treatment effect on occupational performance and satisfaction, which some evidence links to self-efficacy (Thomas et al, 2020 ). Self-efficacy is, in turn, associated with chronic pain prognosis (Martinez-Calderon et al, 2018 ).…”