Item response theory analysis of the Pain Self-Efficacy Questionnaire

Background and aims: The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item instrument designed to assess the extent to which a person in pain believes s/he is able to accomplish various activities despite their pain. There is strong evidence for the validity and reliability of both the full-length PSEQ and a 2-item version. The purpose of this study is to further examine the properties of the PSEQ using an item response theory (IRT) approach. Methods: We used the two-parameter graded response model to examine the category probability curves, and location and discrimination parameters of the 10 PSEQ items. In item response theory, responses to a set of items are assumed to be probabilistically determined by a latent (unobserved) variable. In the graded-response model specifically, item response threshold (the value of the latent variable for which adjacent response categories are equally likely) and discrimination parameters are estimated for each item. Participants were 1511 mixed, chronic pain patients attending for initial assessment at a tertiary pain management centre. Results: All items except item 7 (I can cope with my pain without medication') performed well in IRT analysis, and the category probability curves suggested that participants used the 7-point response scale consistently. Items 6 (I can still do many of the things I enjoy doing, such as hobbies or leisure activity, despite pain'), 8 ('I can still accomplish most of my goals in life, despite the pain') and 9 (I can live a normal lifestyle, despite the pain') captured higher levels of the latent variable with greater precision. Conclusions: The results from this IRT analysis add to the body of evidence based on classical test theory illustrating the strong psychometric properties of the PSEQ. Despite the relatively poor performance of Item 7, its clinical utility warrants its retention in the questionnaire. Implications: The strong psychometric properties of the PSEQ support its use as an effective tool for assessing self-efficacy in people with pain. 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.