Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting

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Abstract
We examined the relationship between functional self-efficacy and pain-related disability in a sample of older veterans with chronic pain. A total of 1045 veterans aged 65 years or older who received primary care at the VA Connecticut Healthcare System in West Haven, CT, were assessed for the presence of chronic pain (i.e. pain due to a non-cancer cause for >/=3 consecutive months in the past 12 months); 303 (26%) screened positive; and 245 (81%) participated. Using a ten-item functional self-efficacy questionnaire (scale: 0-40), participants were categorized into three functional self-efficacy groups: low, score </=26; moderate, score 27-38; and high, score 39-40. Pain-related disability was defined as having one or more days of restricted activity due to pain in the past month. The mean age was 75 years (s.d.=5.1) and most participants were male (84%) and Caucasian (96%). Twenty-five percent of the sample had low, 50% had moderate, and 25% had high functional self-efficacy. The prevalence of pain-related disability was 56%. After adjusting for potential confounders, the likelihood of pain-related disability was significantly higher for those with moderate vs. high (OR=2.05, 95% CI 1.03-4.06) and low vs. high (OR=4.77, 95% CI 1.96-11.61) functional self-efficacy. Functional self-efficacy was a strong and independent factor associated with pain-related disability among older veterans with chronic pain.