Does Pain Self-Efficacy Moderate the Association of Psychosocial Factors with the Health-Related Quality of Life of Patients Scheduled for Lumbar Spine Surgery?

Abstract

Objectives: This study aimed to investigate the moderating role of pain self-efficacy in the association of multiple psychosocial factors with the health-related quality of life (HRQOL) of patients scheduled for lumbar spine surgery.

Methods: This cross-sectional study analyzed 258 patients scheduled for lumbar spine surgery. Data were collected preoperatively using validated tools to measure HRQOL, pain self-efficacy, pain intensity, anxiety and depression, fear of movement, pain catastrophizing, and central sensitization symptoms. Hierarchical multiple regression analysis and simple slope tests were performed to assess the associations of psychosocial factors with HRQOL and the moderating effects of pain self-efficacy on these relationships.

Results: The final model explained 43.8% of the HRQOL variance. Significant interactions were noted between pain self-efficacy and pain intensity (P<0.01), anxiety (P<0.01), fear of movement (P<0.05), and pain catastrophizing (P<0.01). The negative associations of these psychological factors with HRQOL were significant only in the low pain self-efficacy group, whereas these associations were attenuated to nonsignificant levels in the high pain self-efficacy group.

Discussion: In this cross-sectional study, different associations between psychosocial factors and HRQOL were observed based on pain self-efficacy levels in patients awaiting lumbar spine surgery. This finding suggests that pain self-efficacy assessment may help identify high-risk patients who need additional preoperative psychological support.