ó gão o icial da sociedade po uguesa de euma ologia - a c a e u m a o l p o .2011;36:260-267
260
a i g o o i g i n a l
p s y c h o m e i c p o p e i e s o h e
p o u g u e s e e s i o n o h e p a i n
s e l -e i c a c y q u e s i o n n a i e
M. Alexand a Fe ei a-Valen e*,**,***, José L. Pais-Ribei o*,***, Ma k P. Jensen****
*Faculdade de Psicologia e Ciências da Educação da Uni e sidade
do Po o, Po o, Po ugal;
**Fundação pa a a Ciência e a Tecnologia, Po ugal
***Unidade de In es igação em Psicologia e Saúde, ISPA, Lisboa,
Po ugal
****Uni e si y o Washing on School o Medicine, Sea le, USA.
The p esen s udy was unde aken wi h he suppo o he i s
au ho ’s FCT PhD g an SFRH/BD/ 40956/2007.
he hypo hesized di ec ions, suppo ing i s cons -
uc alidi y. Addi ionally, he con i ma o y ac o
analysis suppo ed a single ac o solu ion, as hy-
po hesized.
Conclusions: The indings p o ide s ong suppo
o he eliabili y and alidi y o he P-PSEQ. Re-
sea ch is needed o de e mine he esponsi i y o
he P-PSEQ and o es ablish he gene alizabili y o
he esul s in o he samples o Po uguese pa ien s
wi h ch onic pain.
Keywo ds: Pain; Pain Assessmen ; In ac able Pain;
Sel -E icacy.
In oduc ion
Biopsychosocial models o ch onic pain hypo he-
size ha psychological and social ac o s play a key
ole in he adjus men o ch onic pain. Pain sel -
-e i cacy – ha is, he belie o con idence in one’s
abi li y o engage in a speci ic beha iou o o he
ac ion o achie e desi ed goals despi e pain1-4 – has
been one o he ac o s hough o media e he im-
pac o pain on disabili y and dep ession1,5-7. The e
is s ong suppo o he impo ance o pain sel -e -
icacy ac oss a b oad ange o pain popula ions and
condi ions, wi h pa ien s endo sing highe le els o
sel -e icacy epo ing lowe le els o pain in ensi-
y, disabili y, dep ession and anxie y1,4,5,8-14, and
highe quali y o li e and gene al heal h12,15. Fu -
he mo e, sel -e icacy is hough o in luence
hough s and eelings, which in u n can a ec
unc ioning2,4,16-18. Sel -e icacy may also in luence
he use o pain coping s a egies ia i s e ec s
on eadiness o engage in hose coping espon -
ses4,11,19-21, wi h pa ien s endo sing lowe le els o
sel -e icacy being mo e likely o use passi e co -
ping esponses and o ca as ophize in esponse o
pain4,19. On he o he hand, pa ien s endo sing
highe le els o sel -e icacy ha e been shown o
Abs ac
Aims: This s udy sough o ansla e and e alua e
he psychome ic p ope ies o a Eu opean Po -
uguese e sion o he Pain Sel -E icacy Ques ion-
nai e (P-PSEQ), in o de o enable i s use in clinical
and c oss-cul u al s udies.
Ma e ial and Me hods: The Pain Sel -E icacy Ques-
ionnai e was ansla ed in o Eu opean Po uguese
and hen back- ansla ed in o English. A consensus
e sion o he ansla ed e sion was p e- es ed wi h
a pilo sample, ollowed by cogni i e deb ie ing, e-
sul ing in a inal e sion o he measu e.
A con enience sample o 174 Po uguese adul s
wi h ch onic musculoskele al pain comple ed he
Po uguese Pain Sel -E icacy Ques ionnai e
(P-PSEQ) and c i e ion measu es o pain in ensi y
(Nume ical Ra ings Scale), pain in e e ence (Po -
uguese B ie Pain In en o y In e e ence Scale),
quali y o li e and gene al heal h (SF-12), and psy-
chological unc ioning (Hospi al Anxie y and De-
p ession Scale). C onbach’s alpha and composi e
eliabili y coe icien s we e compu ed as measu es
o eliabili y, and con i ma o y ac o analysis was
pe o med. Pea son co ela ion coe icien s be-
ween he P-PSEQ sco e and he c i e ion measu es
we e compu ed o e alua e he cons uc alidi y o
he scale.
Resul s: The P-PSEQ demons a ed good o excel-
len eliabili y (C onbach’s alpha = 0.88 and Com-
posi e eliabili y = 0.92), and showed mode a ely
s ong associa ions wi h he c i e ion measu es in
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261
m. alexand a e ei a- alen e e col.
use mo e adap i e coping esponses2,11,19,22, e en
a e con olling o demog aphic and medical s a-
us a iables11. Gi en he impo ance o sel -e i-
cacy in he adap i e managemen o ch onic pain,
mul idisciplina y ea men p og ams o en aim
o inc ease pain sel -e icacy as a way o inc ease
pa ien s’ quali y o li e and enhance posi i e phy -
sical and psychological ou comes in esponse o
ea men .
In o de o de e mine he e ec s o ea men on
pain sel -e icacy as well as e alua e i s po en ial
ole in adjus men o pain, a alid and eliable mea-
su e o pain sel -e icacy is needed. Mo eo e ,
ansla ed measu es o he cons uc a e needed
o c oss-cul u al esea ch o de e mine i he same
ea men s ha e simila e ec s on ou comes ac oss
cul u es. The Pain Sel -E icacy Ques ionnai e
(PSEQ)4, which was de eloped om Bandu a’s So-
cial Lea ning heo y2, is he only pain sel -e icacy
measu e de eloped speci ically o assess con i-
dence o pa ien s o engage in a numbe o ac i i-
ies o daily li ing, despi e pain. The PSEQ was de-
eloped o be applicable o pa ien s wi h all ch o -
nic pain condi ions and o be easy o unde s and.
I assesses sel -e icacy ega ding a wide ange o
unc ions such as household cho es, social ac i i-
ies, wo k, and coping wi h pain wi hou medica-
ion, ye akes less han wo minu es o comple e.
P e ious esea ch shows he PSEQ o be eliable
and o ha e bo h ac o ial and p edic i e alidi y
ac oss a numbe o languages, cul u es, and clini-
cal se ings4,9,12,14,23-33.
Al hough a Po uguese e sion o he PSEQ has
been de eloped, i was ansla ed and alida ed o
be used in B azilian popula ions14. Howe e , a Eu-
opean Po uguese e sion o he PSEQ has no ye
been ansla ed and alida ed. A Eu opean Po -
uguese e sion o he PSEQ ha is dis inc om
he B azilian Po uguese e sion is needed because
o he cul u al and language di e ences be ween
Eu opean Po uguese (as spoken in Po ugal) and
B azilian Po uguese.
The pu pose o his s udy is o ansla e and
e alua e he psychome ic p ope ies o a Eu o-
pean Po uguese e sion o he Pain Sel -E icacy
Ques ionnai e (P-PSEQ), o enable i s use in clini-
cal and c oss-cul u al s udies. Based on p e ious
esea ch wi h he PSEQ in o he samples, we hy-
po hesized ha : (1) he in e nal consis ency (C on-
bach’s alpha) o he P-PSEQ would be good o ex-
cellen (abo e 0.80)34; (2) he p edic i e alidi y o
he P-PSEQ would be suppo ed ia a pa e n o
signi ican nega i e associa ions wi h pain in en-
si y ( be ween -0.12 and -0.39)4,5,9,12,14,30 and pain in-
e e ence ( be ween -0.31 and -0.70)5,9,12,14,30, an -
xie y ( be ween -0.49 and -0.56)4,12 and dep ession
( be ween -0.48 and -0.66)4,9,12,30 and mode a e o
s ong co ela ions (i.e., 0.30 o la ge ) wi h mea-
su es o global physical unc ioning and psycho-
logical unc ioning12; and (3) a ac o analysis o
he P-PSEQ i ems would yield one ac o ha ex-
plains a subs an ial po ion o he a iance in he
i ems.
Ma e ials and Me hods
Subjec s
One-hund ed and se en y ou pa ien s, all o e
18 yea s old, wi h ch onic musculoskele al pain
om se en heal h ca e ins i u ions in no he n and
cen al Po ugal comple ed he s udy p o ocol. In-
clusion c i e ia included: (1) expe iencing pain due
o a diagnosed musculoskele al condi ion o a
leas 3 mon hs; (2) being a leas 18 yea s old; (3)
and being willing o pa icipa e in a esea ch. Ex-
clusion c i e ia included: (1) ha ing a physical o
cogni i e disabili y which p e en ed pa icipa ion,
(2) known/diagnosed se e e dep ession o o he
se e e men al heal h condi ion, and (3) pain
due o ib omyalgia. As can be seen in Table I,
he pa icipan s’ ages anged om 23 o 90 yea s
(M = 59.18, SD = 16.11), 60.2% we e ma ied o li -
ing wi h a signi ican o he , 26.3% we e ei he sin-
gle o di o ced/sepa a e and 8.8% o he pa ici-
pan s we e widowed. The majo i y o he pa ici-
pan s we e emale (60.2%). Mos pa icipan s had
a his o y o ch onic pain o a leas wo yea s
(65.3%), and 38.8% epo ed ha ing had pain o
mo e han 10 yea s.
Measu es
All pa icipan s we e asked o p o ide basic de-
mog aphic and pain his o y in o ma ion (e.g. age,
sex, ma i al s a us, le el o educa ion, p o essio nal
s a us, du a ion o pain, pain loca ion and cause o
pain). They we e also asked o a e hei pain in-
ensi y a i s maximum, minimum and on a e age
du ing he p e ious 24hou s on a 0 o 10 Nume i-
cal Ra ing Scale (NRS). Resea ch suppo s he a-
lidi y o he NRS as a measu e o pain in ensi y35.
The Po uguese BPI Pain In e e ence subscale
was used o assess pain in e e ence ac oss se en
daily li e ac i i ies (gene al ac i i y, mood, walking
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262
po uguese pain sel -e icacy ques ionnai e
-e icacy belie s. The 10-i em scale assesses con i-
dence o pa ien s o engage in a numbe o ac i i-
ies o daily li ing despi e pain on 0 - 6 nume ical
a ing scales, whe e 0 = “no a all con iden ” and
6 = “comple ely con iden ”. Highe sco es ( anging
om 0 o 60) e lec s onge sel -e icacy belie s.
P ocedu e
The ini ial phase o he s udy in ol ed ansla ing
and back- ansla ing he ins uc ions and i ems o
he PSEQ. Th ough expe discussion, we a i ed
a a consensus e sion, and e i ied ha i s con en
assessed he same cons uc as he o i gi nal. To en-
su e ha he indi iduals in ou popula ion unde -
s ood he ins uc ions and scale i ems, we hen
pe o med a p e- es o he P-PSEQ in a pilo sam-
ple o 15 pa ien s, ollowed by a cogni i e deb ie -
ing. A e making inal modi ica ions based on he
esul s o he cogni i e es ing, we in i ed a sam-
ple o pa ien s wi h ch onic musculoskele al pain
o comple e all o he s udy measu es. All pa ien s
who ag eed hen signed an in o med consen o m
and we e adminis e ed he 0-10 NRS, P-BPI In e -
e ence Scale, SF-12, HADS and P-PSEQ ques ion-
nai es.
Da a Analysis
Means and s anda d de ia ions o he s udy a ia -
bles we e compu ed o desc ip i e pu poses. In-
e nal consis ency o he P-PSEQ was assessed by
compu ing a C onbach’s alpha. Composi e elia-
bili y was also compu ed41,42. Then, o es a hy-
po hesized one- ac o model o he P-PSEQ i ems,
we pe o med a con i ma o y ac o analysis (CFA).
Model quali y o i ness was e alua ed using he
Chi Squa e (χ2/d ), Compa a i e Fi Index (CFI),
Pa simony Compa a i e Fi Index (PCFI), Good-
ness o Fi Index (GFI), Pa simony Goodness o Fi
Index (PGFI), and Roo Mean Squa e E o o Ap-
p oxima ion (RMSEA). The model was conside ed
o ha e accep able i i χ2/d was less han 5 42-44,
CFI and GFI highe han 0.842, he PCFI and PGFI
we e bo h highe han 0.642,45,46, he RMSEA was lo -
we han 0.1042,43. The model was conside ed o ha -
e a good i i χ2/d was less han 242-44, he CFI and
GFI we e highe han 0.942, PCFI and PGFI highe
han 0.842,45, and he RMSEA was lowe han 0.0843.
Mo del adjus men was pe o med, s ep-by-s ep,
ia Modi ica ion Indices analysis (highe han 11;
p<0.001)42,43 and based on heo y. We also used he
Expec ed C oss-Valida ion Index (ECVI), o com-
pa e i a e models’ adjus men , wi h lowe ECVI
abili y, no mal wo k, ela ions wi h o he people,
sleep, and enjoymen o li e) on 0 o 10 nume ical
a ing scales. Resea ch suppo s he alidi y and e-
liabili y o BPI in se e al samples, cul u es and lan-
guages, including Eu opean Po uguese36-38. The
Po uguese SF-1239 was used as a measu e o pe -
cei ed Physical (Physical Componen Summa y,
PCS) and Men al (Men al Componen Summa y,
MCS) heal h s a us, wi h highe sco es ( anging
om 0 o 100) indica ing be e heal h. The Po -
uguese e sion has e idence suppo ing i s elia-
bili y and alidi y39. The Po uguese e sion o he
Hospi al Anxie y and Dep ession Scale (HADS)40
was used o assess psychological unc ioning. I
asks esponden s o a e he se e i y o 14 dep es-
si e o anxie y symp oms on 4-poin Like scales,
and has shown good eliabili y and alidi y40. The
possible sco es ange om 0 o 21. Highe sco es
e lec highe anxie y o dep essi e symp oma olo -
gy. The Po uguese Pain Sel -E icacy Ques ionnai -
e (P-PSEQ)4was used o assess pain- ela ed sel -
Table I. Demog aphic In o ma ion
Po uguese sample
F equency Mean
(%) (SD)
Age – 59.18
(16.11)
Sex ( emale pa icipan s) 103 (60.2) –
Educa ion Le el
P ima y educa ion 76 (44.7) –
Incomple e High School 35 (20.6) –
High School 27 (15.9) –
College 32 (18.9) –
Ma i al S a us
Single 31 (18.1) –
Ma ied/Li ing wi h o he 103 (60.2) –
Di o ced 15 (8.8) –
Widow 22 (12.9) –
P o essional S a us
Employed 68 (39.8) –
Unemployed 19 (11.1) –
Re i ed (due o disabili y) 47 (27.5) –
Re i ed (no mal age) 37 (21.6) –
Du a ion o Pain
3 mon hs o 1 yea 36 (21.2) –
1 o 2 yea s 23 (13.5) –
2 o 10 yea s 45 (26.5) –
Mo e han 10 yea s 66 (38.8) –
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m. alexand a e ei a- alen e e col.
Resul s
Desc ip i e in o ma ion
As can be seen in Table II, he s udy pa icipan s e-
po ed mild o mode a e le els o pain se e i y
(NRS) and pain- ela ed disabili y (BPI Pain In e -
e ence). Mean sco es o SF-12 Physical Compo-
nen Summa y and SF-12 Men al Componen
Summa y indica e signi ican dys unc ion in hese
a eas, ela i e o published no ms o heal hy in-
di iduals39. O e all, he mean sco es on he HADS
sugges ed mild le els o anxie y, simila o indi-
iduals wi h a a ie y o medical diso de s, and
no mal a ings o dep essi e symp oms40. Finally,
he sample was cha ac e ized by ela i ely high le -
els o sel -e icacy, on a e age, acco ding o he cu
o s sugges ed by Tonkin47 (mean > 40), and when
compa ed o no ma i e da ase s o pa ien s wi h
ch onic pain, as epo ed by Nicholas and col-
leagues48 in a s udy o 6124 pa ien s om ac oss he
Aus alian s a e o New Sou h Wales.
Reliabili y
The P-PSEQ’s in e nal consis encies (C onbach’s
alphas) in ou sample and in p e ious samples a e
lis ed in Table III. The scale shows a e y good le -
el o in e nal consis ency in ou sample ha is
consis en wi h o he samples, wi h an alpha coe -
icien o 0.8834. Values o alpha i single i ems a e
dele ed a e compa able o he o e all alpha, sug-
Table II. Desc ip i e S a is ics S udy Va iables
Min-
Mean (SD) Max
Pain In ensi y (NRS)
Maximum (las 24 hou s) 5.70 (2.49) 0-10
Minimum (las 24 hou s) 2.97 (2.25) 0-9
A e age Pain 4.59 (2.18) 0-10
Pain In e e ence (P-BPI) 4.03 (2.44) 0-9
Physical Componen 39.07 (23.51) 0-100
Summa y (SF-12)
Men al Componen 57.02 (20.39) 10-100
Summa y (SF-12)
Anxie y (HADS-A) 7.58 (3.91) 1-20
Dep ession (HADS-D) 6.07 (3.87) 0-17
Sel E icacy (P-PSEQ) 40.83 (11.31) 6-60
No e: NRS = Nume ical Ra ing Scale o pain in ensi y; P-BPI =
Po uguese B ie Pain In en o y – In e e ence scale; HADS-A =
Hospi al Anxie y and Dep ession Scale – Anxie y scale; HADS-D =
Hospi al Anxie y and Dep ession Scale – Dep ession scale; P-PSEQ =
Po uguese Pain Sel -E icacy Ques ionnai e.
Table III. Reliabili y Analyses o B ie Pain In en o y In e e ence Scale
P-PSEQ To al scale
o i em Ou sample Aus alia4B azil14 China12 I an9
C onbach's Alpha
P-PSEQ To al scale 0.88 0.92 0.90 0.93 0.92
C onbach's Alpha i i em dele ed (I em To al Co ela ion)
P-PSEQ I ems
I em 1 0.87 (0.48) - (0.70) - (0.79) 0.92 (0.72) –
I em 2 0.86 (0.56) - (0.72) - (0.73) 0.92 (0.71) –
I em 3 0.86 (0.61) - (0.71) - (0.67) 0.92 (0.66) –
I em 4 0.85 (0.70) - (0.83) - (0.71) 0.92 (0.66) –
I em 5 0.86 (0.61) - (0.74) - (0.76) 0.92 (0.71) –
I em 6 0.85 (0.67) - (0.79) - (0.77) 0.92 (0.81) –
I em 7 0.88 (0.43) - (0.67) - (0.50) 0.93 (0.62) –
I em 8 0.86 (0.62) - (0.79) - (0.82) 0.92 (0.80) –
I em 9 0.85 (0.72) - (0.84) - (0.80) 0.92 (0.78) –
I em 10 0.86 (0.63) - (0.84) - (0.79) 0.92 (0.75) –
No e: P-PSEQ = Po uguese Pain Sel -E icacy Ques ionnai e
e lec ing be e i . Finally, Pea son co ela ion co-
e icien s be ween he P-PSEQ sco e (o sco es) and
he c i e ion measu es we e compu ed o e alua e
he cons uc alidi y o he scale. S a is ical ana -
lyses we e pe o med using so wa e PASW S a is-
ics ( .18, SPSS Inc. Chicago, IL) and AMOS ( .18,
SPSS Inc. Chicago, IL).
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264
po uguese pain sel -e icacy ques ionnai e
ges ing ha no i em de ac s om he eliabili y o
he measu e. Addi ionally, he Composi e Reliabi -
li y coe icien 41,42 o 0.92 indica es excellen elia-
bili y34,41,42,49.
Fac o Analysis
A ac o analysis o he PSEQ in he o iginal scale
de elopmen sample esul ed in a single ac o ha
accoun ed o 59% o he a iance. This esul has
been eplica ed in o he samples o pa ien s om
B azil14 and China12. We used a con i ma o y ac o
analysis, using maximum likelihood o es ima e
model pa ame e s, o de e mine he i o a single
ac o model. Fou o he se en combined i
indices o he CFA suppo ed a one- ac o solu ion
wi h accep able i . Howe e , he i ness quali y
o he one- ac o solu ion appea ed somewha
limi ed in ou sample [χ2(35) = 155.58 (p<0.001);
χ2/d = 4.44; CFI = 0.83; PCFI = 0.65; GFI = 0.84;
PGFI = 0.54; RMSEA = 0.14 (p<0.001); ECVI = 1.15]
(Figu e 1).
Inspec ion o P-PSEQ i ems sugges s ha some
i ems ha e e y simila con en , which could po-
en ially explain he educed i ness le els o he
one- ac o solu ion. Fo example, I em 2 (“I can do
mos household cho es (e.g. idying-up, washing
dishes, e c.), despi e he pain”) and I em 5 (“I can
do some o m o wo k, despi e he pain. (“wo k” in-
cludes housewo k, paid and unpaid wo k)”) ap-
pea o assess a e y simila domain, as do I em 8
(“I can s ill accomplish mos o my goals in li e,
des pi e he pain”) and I em 9 (“I can li e a no mal
li es yle, despi e he pain”). Based on an inspec ion
o he modi ica ion indexes, speci ic e o e ms
Fi gu e 1. Con i ma o y Fac o Analysis: Ini ial Model
χ2(35) = 155.58 (p<0.001); χ2/d = 4.44; CFI = 0.83;
PCFI = 0.65; GFI = 0.84; PGFI = 0.54; RMSEA = 0.14
(p<0.001); ECVI = 1.15
Fi gu e 2. Con i ma o y Fac o Analysis: Final Model
χ2(33) = 66.95 (p<0.001); χ2/d = 2.03; CFI = 0.95;
PCFI = 0.70; GFI = 0.93; PGFI = 0.56; RMSEA = 0.08
(p=0.05); ECVI = 0.65

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265
m. alexand a e ei a- alen e e col.
we e co ela ed sequen ially, which esul ed in a
new model (Figu e 2) ha main ained all he i ems
o he o iginal P-PSEQ.
A e aking in o accoun he e o e m co ela-
ions, he combined i indices o he CFA, suppo
he one ac o solu ion hypo hesized [χ2(33) = 66.95
(p<0.001); χ2/d = 2.03; CFI = 0.95; PCFI = 0.70;
GFI = 0.93; PGFI = 0.56; RMSEA = 0.08 (p=0.05);
ECVI = 0.65], wi h six o he se en combined i in-
dices o he CFA suppo ing his solu ions, wi h
accep able o good i . This new model e ealed a
goodness o i signi ican ly hi ghe han he ini ial
model [χ2(33) = 66.95 (p < 0.001), and ECVI conside -
ably di e en : 1.15 s. 0.65].
Co ela ional Analysis
Table IV p esen s he Pea son co ela ion coe i-
cien s compu ed be ween he P-PSEQ sco e and
he c i e ion a iables. As hypo hesized, s a is i-
cally signi ican nega i e associa ions we e ound
be ween he sel -e icacy sco e and pain in ensi y
[ anging be ween -0.27 and -0.32, p < 0.01], pain in-
e e ence [ = -0.41, p < 0.01], anxie y [ = -0.39,
p < 0.01] and dep ession [ = -0.55, p < 0.01]. Mo e-
o e , a s a is ically signi ican posi i e associa ion
was ound be ween he P-PSEQ sco e and he SF-12
Physical Heal h sco e [ = 0.51, p < 0.01] and SF-12
Men al Heal h sco e [ = 0.46, p < 0.01]. All o he sig-
ni ican associa ions we e in he hypo hesized di-
ec ions and showed magni udes ha we e wi hin
he an icipa ed anges, wi h he excep ion o anxie -
y, which was sligh ly lowe han expec ed, al hough
e en o his c i e ion a mode a e associa ion wi h
sel -e icacy in he hypo hesized di ec ion was
ound.
Discussion
Consis en wi h p e ious indings o o he e sions
o he PSEQ, ou esul s p o ide s ong suppo o
he eliabili y and alidi y o he Po uguese PSEQ.
I s in e nal consis ency (C onbach’s alpha) is
g ea e han 0.80, indica ing good eliabili y. Mo e-
o e , i s Composi e Reliabili y coe icien o 0.92 in-
dica es excellen eliabili y34,41,42,49. These alues a e
simila o hose ound in he o igi nal scale de elop -
men sample and o he ansla ed e sions o he
measu e4,9,12,14. In addi ion, he esul s o a con i -
ma o y ac o analysis suppo a one ac o solu-
ion41-46,50 and p o ides u he suppo o a high
le el o in e nal consis ency. The co ela ion coe -
icien s be ween P-PSEQ scale sco e and c i e ion
measu es a e consis en wi h hose ound in p e i-
ous s udies4,9,12,14,30, and suppo he alidi y o he
P-PSEQ.
Consis en wi h p e ious esea ch1,4,5,8-14, ou
indings suppo he impo ance o sel -e icacy as
a p edic o o adjus men o ch onic pain, gi en i s
signi ican associa ions wi h pain in ensi y, phy -
sical and psychological unc ioning (pain in e e -
ence, anxie y and dep ession), as well as wi h glo -
bal quali y o li e and gene al heal h12,15. As a g oup,
he indings om he cu en and p e ious s udies
sugges ha he concep and e ec s o pain sel -e -
icacy a e simila ac oss cul u es, in line wi h he
indings a ailable o he e ec s o sel -e icacy be-
lie s on pe o mance17,51.
The e a e a numbe o s udy limi a ions ha
should be conside ed when in e p e ing he in -
dings. Fi s , we employed a c oss-sec ional co e-
la ional design. As a esul , we we e unable o exa -
mine he es - e es s abili y o he P-PSEQ. Also,
such a design does no allow o an e alua ion o he
causal e ec s o sel -e icacy on unc ioning. Fu -
he esea ch is needed o s udy he s abili y o
P-PSEQ sco e o e ime, as well as o de e mine he
po en ial bene icial e ec s o in e en ions ha in-
c ease pain sel -e icacy belie s. Second, he s udy
sample was one o con enience. We we e no able
o de e mine how ep esen a i e he sample is o
Table IV. Co ela ions wi h Measu es o Pain
In ensi y, Physical Dys unc ion and Psychological
Func ioning
Sel -E icacy
Scale (P-PSEQ)
Pain In ensi y (NRS)
Maximum (las 24 hou s) -0.27**
Minimum (las 24 hou s) -0.32**
A e age Pain -0.28**
Pain In e e ence (P-BPI) -0.41**
Physical Func ioning (SF-12, PCS) 0.51**
Men al Heal h (SF-12, MCS) 0.46**
Anxie y (HADS-A) -0.39**
Dep ession (HADS-D) -0.55**
**p < 0.01
No e: P-PSEQ = Po uguese Pain Sel -E icacy Ques ionnai e;
NRS = Nume ical Ra ing Scale o pain in ensi y; P-BPI = Po uguese
B ie Pain In en o y – In e e ence scale; HADS-A = Hospi al Anxie y
and Dep ession Scale – Anxie y scale; HADS-D = Hospi al Anxie y
and Dep ession Scale – Dep ession scale
ó gão o icial da sociedade po uguesa de euma ologia - a c a e u m a o l p o .2011;36:260-267
266
po uguese pain sel -e icacy ques ionnai e
he popula ion o pa ien s in Po ugal wi h ch o -
nic musculoskele al pain. Resea ch is he e o e
needed o help es ablish he gene alizabili y o he
indings. Thi d, we did no adminis e o he mea-
su es o sel -e icacy o help es ablish he con e -
gen alidi y o he P-PSEQ. Addi ional esea ch is
needed o help de e mine he ex en o o e lap be-
ween he P-PSEQ and o he pain sel -e icacy
measu es.
Ne e heless, ou indings p o ide suppo o
he eliabili y and alidi y o he Po uguese PSEQ,
and sugges ha he measu e may be use ul o
unde s anding he impo ance o he sel -e icacy
concep o pain and adjus men o pain in Po -
uguese pa ien s wi h ch onic pain, as well as o
c oss-cul u al esea ch examining simila i ies and
di e ences in he ole ha sel -e icacy plays in pa-
ien s om Po ugal and pa ien s om o he coun-
ies and cul u es.
Acknowledgmen s
M. Alexand a Fe ei a-Valen e has ecei ed PhD g an
SFRH/BD/ 40956/2007 in he pas yea om he Po -
uguese Founda ion o Science and Technology.
Co espondence o
M. Alexand a Fe ei a-Valen e
Rua 25 de Ab il, n.º 5, Idanha – Belas
2605-119 Belas, Po ugal
Phone: (00351) 969082988
E-mail: [email p o ec ed]
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