Cited by 241Musculoskeletal pain and rehabilitationPain Management and Opioid UsePsychometric Methodologies and Testing

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A 2-Item Short Form of the Pain Self-Efficacy Questionnaire: Development and Psychometric Evaluation of PSEQ-2

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Nicholas, Michael K., McGuire, Brian E., Asghari, Ali·2015·The Journal of Pain

DOI 10.1016/j.jpain.2014.11.002

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Abstract

Unlabelled The Pain Self-Efficacy Questionnaire (PSEQ) is an established 10-item measure of pain self-efficacy that is widely used in clinical and research settings. However, a shorter measure would reduce patient and researcher burden and save valuable time in busy clinical settings. The aim of this study was to develop and confirm the psychometric properties of a valid and reliable 2-item short form of the PSEQ (PSEQ-2). We used a large sample of 1,418 chronic pain patients, which we randomly split into 2 smaller groups. We identified the 2 short-form items in Sample 1 and confirmed their properties in Sample 2. In order to identify the 2 items for the short-form measure, we selected the first item based on the highest item-total correlation. The second item was identified after a series of additional analyses. The 2 items identified from the PSEQ reflected confidence in one's ability to work and lead a normal life despite pain. The PSEQ-2's validity and internal consistency were found to be sound. Test-retest reliability, sensitivity to change, and convergent validity were confirmed in a separate patient sample (n = 140) that had recently completed an intervention designed, in part, to modify self-efficacy beliefs. The PSEQ-2 appears to be a robust measure of pain self-efficacy.Perspective Pain self-efficacy is a belief in one's ability to carry out activities even when in pain and is important in coping effectively with pain. A short measure of pain self-efficacy was developed and evaluated. It appears to be suitable for use in clinical and research settings.

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Method
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Shigetoh, H., Nishi, Y., Osumi, M., & Morioka, S. (2020) · PLoS ONE · doi:10.1371/journal.pone.0244111 · Cited by 16
“The PSEQ-2 is a shorter version of a 10-item PSEQ and contains two items [37].”
Sensitivity to movement‐evoked pain, central sensitivity symptoms, and pro‐nociceptive profiles in people with chronic shoulder pain: A parallel‐group cross‐sectional investigation
Othman, R., Swain, N., Tumilty, S., Jayakaran, P., & Mani, R. (2022) · Pain Practice · doi:10.1111/papr.13152 · Cited by 17
“Pain self- efficacy The short form of pain self- efficacy questionnaire (PSEQ2) was used in the current study.(58,59) The PSEQ2 short form consists of item 5 (i.”
BackgroundMethodInfluential
Construct Validity and Internal Consistency of the Catalan Version of the Pain Self-Efficacy Questionnaire in Young People With Chronic Pain
Castarlenas, E., Solé, E., Galán, S., Racine, M., Jensen, M. P., & Miró, J. (2018) · Evaluation & the Health Professions · doi:10.1177/0163278718820410 · Cited by 16
Clinically Important Change in Insomnia Severity After Chronic Pain Rehabilitation
Wilson, K. G., Kowal, J., & Ferguson, E. J. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000325 · Cited by 15
Virtual Reality Body Image Training for Chronic Low Back Pain: A Single Case Report
Harvie, D. S., Rio, E., Smith, R., Olthof, N. A., & Coppieters, M. W. (2020) · Frontiers in Virtual Reality · doi:10.3389/frvir.2020.00013 · Cited by 16
“, 1995), and Self-efficacy was measured using the Pain Self-efficacy Questionnaire (PSEQ-2) (Nicholas et al., 2015).”
BackgroundMethod
Pain-Related Fear in Adults Living With Chronic Pain: Development and Psychometric Validation of a Brief Form of the Tampa Scale of Kinesiophobia
Bisson, E. J., Katz, L., Vader, K., Bossio, J. A., Wilson, R. A., & Duggan, S. (2021) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2021.09.001 · Cited by 16
Difficult life events affect lower extremity illness
Salman, A. A., Khatiri, M. Z., Cremers, T., Ring, D., Thomas, J. E., & Fatehi, A. (2020) · Archives of Orthopaedic and Trauma Surgery · doi:10.1007/s00402-020-03686-y · Cited by 14
Examining the roles of depression, pain catastrophizing, and self-efficacy in quality of life changes following chronic pain treatment
Montag, L. T., Salomons, T. V., Wilson, R. A., Duggan, S., & Bisson, E. J. (2022) · Canadian Journal of Pain · doi:10.1080/24740527.2022.2156330 · Cited by 16
“Pain self-efficacy was measured using the Short Form Pain Self-Efficacy Scale (PSEQ-2).(46) PSEQ-2 is a two-item measure where participants indicate the degree to which they believe they can complete daily tasks on a 7-point scale (0 = not at all confident, 6 = completely confident).”
Method
Decision Support for Managing Common Musculoskeletal Pain Disorders: Development of a Case-Based Reasoning Application
Granviken, F., Vasseljen, O., Bach, K., Jaiswal, A. D., & Meisingset, I. (2024) · JMIR Formative Research · doi:10.2196/44805 · Cited by 14
Tailored exercise and manual therapy versus standardised exercise for patients with shoulder subacromial pain: a feasibility randomised controlled trial (the Otago MASTER trial)
Ribeiro, D. C., Tangrood, Z. J., Wilson, R., Sole, G., & Abbott, J. H. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-053572 · Cited by 14
There is Little or No Association Between Independently Assessed Communication Strategies and Patient Ratings of Clinician Empathy
Brown, L. E., Chng, E., Kortlever, J. T. P., Ring, D., & Crijns, T. J. (2022) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000002482 · Cited by 13
“The two-item Pain SelfEfficacy Questionnaire is the two-item version of the full Pain Self-Efficacy Questionnaire and measures effective pain coping in response to nociception [4, 15, 22].”
Method
Prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM): short term effects of a randomised controlled trial in primary care
Ekhammar, A., Grimby‐Ekman, A., Bernhardsson, S., Holmgren, K. E., Bornhöft, L., Nordeman, L., & Larsson, M. E. H. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2343424 · Cited by 13
“Patient-reported pain self-efficacy PSEQ-2 is a two-item short form of the Pain Self-Efficacy Scale (PSEQ), which is a valid, reliable and well-established measure of changes of beliefs held regarding the possibility to carry out certain activities despite pain [44].”
Process of change for people with knee osteoarthritis undergoing cognitive functional therapy: a replicated single-case experimental design study
Cañeiro, J. P., O’Sullivan, P., Tan, J.-S., Klem, N.-R., de Oliveira, B., Choong, P., Dowsey, M. M., Bunzli, S., & Smith, A. J. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2221459 · Cited by 12
“…and Osteoarthritis Outcome Scale (KOOS) [28]; Pain control measured by a single-item from Coping Strategy Questionnaire [29]; and Pain self-efficacy measured by the Pain Self-Efficacy Questionnaire-2 [30]; Pain catastrophising measured by 3-items from the Pain Catastrophising Scale (PCS) [31].”
Method
Clinical Efficacy of Virtual Reality Cave Automatic Virtual Environments (CAVE) for Chronic Musculoskeletal Pain in Older Adults: A Randomized Controlled Trial
Lo, H. H. M., Fong, H. P.-Y., Wang, B., Fung, C. L.-C., Wong, S. Y. S., & Sit, R. W. S. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105344 · Cited by 12
Are Patient Linguistic Tones Associated with Mental Health and Perceived Clinician Empathy?
Salman, A. A., Kim, A., Mercado, A. E., Ring, D., Doornberg, J. N., Fatehi, A., & Crijns, T. J. (2021) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.21.00124 · Cited by 13
Adherence to self-managed exercises for patients with persistent subacromial pain: the Ad-Shoulder feasibility study
Major, D. H., Grotle, M., Littlewood, C., Brox, J. I., Matre, D., Gallet, H. V., & Røe, Y. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00767-6 · Cited by 14
Differential effects of everyday-life social support on chronic pain
Weiss, M. H., Jachnik, A., Lampe, E. C., Gründahl, M., Harnik, M. A., Sommer, C., Rittner, H. L., & Hein, G. (2024) · BMC Neurology · doi:10.1186/s12883-024-03792-z · Cited by 11
“…scale (LSNS-6; [39]; 6 items with scores ranging on a scale from 0 to 5; α = 0.87), the 2-item short form of the pain self-efficacy questionnaire ([40]; 2 items on a 7-point Likert scale; α = 0.98) as well as the loneliness and isolation during social distancing scale ([41]; 25 items on a 5-point…”
Influential
Personalised decision support in the management of patients with musculoskeletal pain in primary physiotherapy care: a cluster randomised controlled trial (the SupportPrim project)
Granviken, F., Meisingset, I., Bach, K., Bones, A. F., Simpson, M. R., Hill, J. C., van der Windt, D., & Vasseljen, O. (2024) · Pain · doi:10.1097/j.pain.0000000000003456 · Cited by 11
Prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal pain (PREVSAM): a randomised controlled trial protocol
Larsson, M. E. H., Nordeman, L., Holmgren, K. E., Grimby‐Ekman, A., Hensing, G. K. E., Björkelund, C., Bergman, S., Ekhammar, A., Dottori, M. G., & Bernhardsson, S. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03790-5 · Cited by 11
“The PSEQ-2 has evidence of validity and reliability in people experiencing chronic pain [37].”
Background
Disparities in Service and Clinical Outcomes in State-Wide Advanced Practice Physiotherapist-Led Services
Raymer, M. E., Mitchell, L. E., Window, P., Cottrell, M. A., Comans, T. A., & O’Leary, S. P. (2021) · Healthcare · doi:10.3390/healthcare9030278 · Cited by 11
A longitudinal investigation of the factors associated with increased RISk of playing-related musculoskeletal disorders in MUsic students (RISMUS): a study protocol
Cruder, C., Koufaki, P., Barbero, M., & Gleeson, N. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2440-4 · Cited by 11
“Cohort 2: participants with PRMDs or MSK conditions (<12 months) • PRMDs • NMQ • Pain management 2-3 months ago; 4-6 months ago; up to 12 months ago • Physical activity: IPAQ • Anxiety and stress: K-10 • Perfectionism: HFMPS-SF • Fatigue: CFQ-11 • Physical activity: IPAQ • Anxiety and stress: K-10 • Perfectionism: HFM…”
MethodInfluential
The smallest worthwhile effect of surgery versus non-surgical treatments for sciatica: a benefit-harm trade-off study
Salame, A., Ferreira, M. L., Hansford, H. J., Maher, C. G., Zadro, J. R., Lin, C. C., Diwan, A. D., McAuley, J. H., Hancock, M. J., Harris, I. A., et al. (2025) · Journal of physiotherapy · doi:10.1016/j.jphys.2025.02.012 · Cited by 10
Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain
Fatoye, F., Mbada, C. E., Oladayo, T. O., Idowu, O. A., Oyewole, O. O., Fatoye, C., & Oke, K. I. (2020) · Spine · doi:10.1097/brs.0000000000003870 · Cited by 10
“It is a well-known self-report measure used across various cultures, in different clinics, and research settings for assessing self-efficacy beliefs in people with chronic pain.(9,11,12) There is diversity in the expression of pain and use of various healthcare systems across cultural groups.”
Background
Catastrophic Thinking and Pain Alleviation After Lower Extremity Surgery
Nunziato, C. A., Fatehi, A., Driscoll, M. D., Koenig, K. M., Ring, D., & Laverty, D. C. (2020) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0000000000001917 · Cited by 10
Prognostic ability of STarT Back Screening Tool combined with work-related factors in patients with low back pain in primary care: a prospective study
Unsgaard‐Tøndel, M., Vasseljen, O., Nilsen, T. I. L., Myhre, G., Robinson, H. S., & Meisingset, I. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046446 · Cited by 10
Benign or painful? The interpretation of pain and fear of progression in rheumatoid arthritis
Boyse, J. B., Sharpe, L., Richmond, B., Dear, B., Dudeney, J., Sesel, A.-L., & Menzies, R. E. (2024) · Pain · doi:10.1097/j.pain.0000000000003081 · Cited by 11
Measurement properties of patient-reported outcome measures used in rehabilitation of adults with chronic musculoskeletal pain: A mapping review
Köke, A. J. A., Bastiaenen, C. H. G., Kleijnen, J., Telgenkamp, I., Smeets, R., & Beckers, L. W. M. E. (2022) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-220133 · Cited by 9
The Effectiveness of Active Learning Approaches in a Pain Education Curriculum Within a Physical Therapy Program
Helms, J. T., Mayhew, T. P., & Zimney, K. J. (2021) · Journal of Physical Therapy Education · doi:10.1097/jte.0000000000000191 · Cited by 10
When Musculoskeletal Clinicians Respond to Empathetic Opportunities, do Patients Perceive Greater Empathy?
Pierson, S. R., Ngoue, M., Lam, R., Rajagopalan, D., Ring, D., & Ramtin, S. (2023) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000002614 · Cited by 9
“The Pain Self-Efficacy Questionnaire is a two-item measure of patient confidence in accomplishing goals and leading a normal life despite pain, with high scores indicating greater self-efficacy [50] and an MCID of 1.”
Pain Self-Efficacy (PSEQ) score of <22 is associated with daily opioid use, back pain, disability, and PROMIS scores in patients presenting for spine surgery
Mo, K., Gupta, A., Movsik, J., Covarrubius, O., Greenberg, M., Riley, L. H., Kebaish, K. M., Neuman, B. J., & Skolasky, R. L. (2023) · The Spine Journal · doi:10.1016/j.spinee.2022.12.015 · Cited by 9
The Study of Reliability and Validity of the Pain Coping Inventory
UZUNKAYA, A. H. (2018) · Ağrı - The Journal of The Turkish Society of Algology · doi:10.5505/agri.2018.46503 · Cited by 9
“Ağrıya ilişkin özetkinlik inançlarının iki maddelik kısa soru formu,[22] katılımcıların ağrıyla başetmeye ilişkin özetkinlik inançlarını tespit etmek amacıyla araştırmacı tarafından Türkçe’ye çevrilerek kullanılmıştır.”
The Fear Reduction Exercised Early (FREE) approach to low back pain: study protocol for a randomised controlled trial
Darlow, B. J. S., Stanley, J., Dean, S. G., Abbott, J. H., Garrett, S., Mathieson, F. M., & Dowell, A. C. (2017) · Trials · doi:10.1186/s13063-017-2225-8 · Cited by 9
Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews
Sim, A., McNeilage, A. G., Gholamrezaei, A., Rebbeck, T., & Ashton-James, C. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085778 · Cited by 8
“3 In the context of injury, distress is often associated with concerns about pain (‘pain catastrophising’), low self-efficacy for coping with pain 4 and negative treatment expectations (ie, the anticipation of poor prognosis).”
Background
Development and internal validation of a multivariable prognostic model to predict chronic pain after a new episode of non-specific idiopathic, non-traumatic neck pain in physiotherapy primary care practice
Verwoerd, M. J., Wittink, H. M., Maissan, F., Teunis, M., van Kuijk, S. M. J., & Smeets, R. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-086683 · Cited by 9
Identifying and optimizing psychosocial frailty in surgical practice
Schultz, K. S., Richburg, C. E., Park, E. Y., & Leeds, I. L. (2024) · Seminars in Colon and Rectal Surgery · doi:10.1016/j.scrs.2024.101061 · Cited by 8
Yoga vs Stretching in Veterans With Chronic Lower Back Pain and the Role of Mindfulness: A Pilot Randomized Controlled Trial
Rae, L. R., Dougherty, P. E., & Evertz, N. (2020) · Journal of Chiropractic Medicine · doi:10.1016/j.jcm.2019.10.005 · Cited by 8
Which Scale to Assess Pain Self-efficacy Shows Better Measurement Properties in Chronic Low Back Pain? A Head-To-Head Comparison Study
Turci, A. M., Spavieri, J. H. P., de Lima, T. C., da Silva, A. P., Cristofolletti, A., & Chaves, T. C. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.05.014 · Cited by 8
Scale Shortening and Decrease in Measurement Precision: Analysis of the Pain Self-Efficacy Questionnaire and Its Short Forms in an Italian-Speaking Population With Neck Pain Disorders
Monticone, M., Giordano, A., & Franchignoni, F. P. (2021) · Physical Therapy · doi:10.1093/ptj/pzab039 · Cited by 8
Social Media-Based Pain Neuroscience Education for Temporomandibular Joint Disorder: A Randomized Controlled Trial
Cho, Y., Jung, Y. L., Im, A., Hong, S. J., & Kim, K. (2025) · Pain Management Nursing · doi:10.1016/j.pmn.2024.12.010 · Cited by 8
Prospective Cohort Study to Investigate Factors Associated With Continued Immobilization of a Nondisplaced Scaphoid Waist Fracture
Bulstra, A. E. J., Hendrickx, L. A. M., Sierevelt, I. N., Buijze, G. A., Kerkhoffs, G. M. M. J., Ring, D., Jaarsma, R. L., & Doornberg, J. N. (2021) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2021.03.027 · Cited by 7
Initial effect of high-volume mobilisation with movement on shoulder range of motion and pain in patients with rotator cuff-related shoulder pain: protocol for a randomised controlled trial (Evolution Trial)
Wang, S., Zeng, J., Chapple, C., Mani, R., & Ribeiro, D. C. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069919 · Cited by 8
Patient-reported outcome measures for patients with hand-specific impairments—A scoping review
Woythal, L., Comins, J. D., & Brorson, S. (2020) · Journal of Hand Therapy · doi:10.1016/j.jht.2020.08.003 · Cited by 7
Regaining the intention to live after relief of intractable phantom limb pain: A case study
Munoz-Novoa, M., van Veldhoven, J. E., Postema, S. G., Kristoffersen, M., Keesom, E., Lendaro, E., Lidström-Holmqvist, K., Ortiz-Catalan, M., & van der Sluis, C. K. (2025) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2025-0006 · Cited by 6
Individual‐Level Effects of a Digital Behavioural Treatment for Chronic Pain: Proof‐of‐Concept of a Single‐Case Experimental Design Study
Sharaa, H. A., Bartels, S. L., Taygar, A. S., Engman, L., Petersson, S., Flink, I. K., Boersma, K., McCracken, L. M., Simons, L. E., Vlaeyen, J. W. S., et al. (2025) · European Journal of Pain · doi:10.1002/ejp.70128 · Cited by 7
Combining goal setting and achievement with occupational therapy to improve pain, psychological factors and physical activity in patients after high tibial osteotomy: A non-randomized controlled study
Hiraga, Y., Hisano, S., Hara, R., 許山勝弘, Hirakawa, Y., & Hida, K. (2021) · Hong Kong Journal of Occupational Therapy · doi:10.1177/1569186120985296 · Cited by 6
“The PSEQ-2 consists of two items scored on a seven-point scale, with anchors at ‘0’ (not at all confident) and ‘6’ (completely confident).”
Method
Telerehabilitation for persistent Pelvic Girdle Pain within a biopsychosocial framework - A case report
Starzec‐Proserpio, M., & Vandyken, C. (2022) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2022.2069618 · Cited by 6

Authors: Nicholas, M. K., McGuire, B. E., & Asghari, A.
Affiliations: The University of Sydney (AU)
Ollscoil na Gaillimhe – University of Galway (IE)
Shahed University (IR)
Corresponding author: Nicholas, Michael K.
ORCID: Nicholas, Michael K.
McGuire, Brian E.
Venue: The Journal of Pain
Publisher: Elsevier BV
Published: 2015-02
Volume: 16
Issue: 2
Pages: 153-163
ISSN: 1526-5900 (ISSN-L)
DOI: 10.1016/j.jpain.2014.11.002
OpenAlex: W1975558470
Cited by: 241
References: 71
Citations by year: 2026: 21 · 2025: 35 · 2024: 38 · 2023: 24 · 2022: 23 · 2021: 35 · 2020: 29 · 2019: 14 · 2018: 7 · 2017: 9 · 2016: 5 · 2015: 1
FWCI: 3.63
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3144 d)
Locations: Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: pain self-efficacy, Pain Self-Efficacy Questionnaire, short-form questionnaire, chronic pain, psychometric properties, test-retest reliability, sensitivity to change, convergent validity, internal consistency, pain coping, self-efficacy measurement
MeSH terms: Adult, Aged, Depression, Female, Humans, Male, Middle Aged, Pain, Phobic Disorders, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Reproducibility of Results, Self Efficacy, Catastrophization

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A 2-Item Short Form of the Pain Self-Efficacy Questionnaire: Development and Psychometric Evaluation of PSEQ-2

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