Spine · 2025
Factors Associated With the Decision to Undergo Spine Surgery: The Role of Self-Efficacy, Pain Tolerance, and Resilience.
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Haldeman Pearce B, Shah Kishan S, Shahidi Bahar, Stephan Stephen R, Nosewicz Camille R, Reid Daniel B C, Malone Hani, Mundis Gregory M, Eastlack Robert K
Аннотация
STUDY DESIGN: Prospective cohort study.
OBJECTIVE: To compare demographic, psychosocial, and lifestyle factors between patients who chose to undergo spine surgery and those who did not.
SUMMARY OF BACKGROUND DATA: The decision to undergo spine surgery is both complex and multifaceted, as it is influenced by a combination of clinical and psychological symptom management behaviors. Specifically, psychosocial metrics, such as resilience and pain self-efficacy, have demonstrated important relationships between spine surgery outcomes.
METHODS: Adult patients at a single academic institution from 2020 to 2022 who were seeking consultation from a spine surgeon were administered questionnaires during their visit, which included the Brief Resilience Scale (BRS), 2-question Pain Self-Efficacy Questionnaire (PSEQ-2), and a pain tolerance question. Baseline demographic, social, and clinical metrics were recorded. Patients were followed for a mean of 44 months. Individuals who underwent surgery were assigned to the operative group (OP) and those who did not were assigned to the nonoperative group (non-OP).
RESULTS: A total of 269 patients had full survey data and were included. 85 in the OP group and 184 in the non-OP group. Significant differences between the groups were observed with respect to age (OP: 65.0 y vs. non-OP: 59.4 y, P =0.0112) and time of consult Visual Analog Scale (VAS) pain scores (OP: 6.57 vs. non-OP: 5.13, P <0.001). The non-OP group reported higher pain self-efficacy scores (PSEQ-2) compared with the OP group (7.11 vs. 5.69, P =0.00108). Regression analysis adjusting for VAS pain scores showed higher PSEQ-2 was independently associated with remaining nonoperative (OR=0.917; 95% CI[0.841, 0.997]).
CONCLUSION: Higher pain self-efficacy, independent of pain level, was associated with a lower likelihood of undergoing spine surgery, suggesting that a patient's perception of their ability to manage their symptoms factors into the choice to undergo surgery. These findings highlight the importance of psychosocial factors, such as pain self-efficacy, in surgical decision-making and may inform patient counseling strategies.
OBJECTIVE: To compare demographic, psychosocial, and lifestyle factors between patients who chose to undergo spine surgery and those who did not.
SUMMARY OF BACKGROUND DATA: The decision to undergo spine surgery is both complex and multifaceted, as it is influenced by a combination of clinical and psychological symptom management behaviors. Specifically, psychosocial metrics, such as resilience and pain self-efficacy, have demonstrated important relationships between spine surgery outcomes.
METHODS: Adult patients at a single academic institution from 2020 to 2022 who were seeking consultation from a spine surgeon were administered questionnaires during their visit, which included the Brief Resilience Scale (BRS), 2-question Pain Self-Efficacy Questionnaire (PSEQ-2), and a pain tolerance question. Baseline demographic, social, and clinical metrics were recorded. Patients were followed for a mean of 44 months. Individuals who underwent surgery were assigned to the operative group (OP) and those who did not were assigned to the nonoperative group (non-OP).
RESULTS: A total of 269 patients had full survey data and were included. 85 in the OP group and 184 in the non-OP group. Significant differences between the groups were observed with respect to age (OP: 65.0 y vs. non-OP: 59.4 y, P =0.0112) and time of consult Visual Analog Scale (VAS) pain scores (OP: 6.57 vs. non-OP: 5.13, P <0.001). The non-OP group reported higher pain self-efficacy scores (PSEQ-2) compared with the OP group (7.11 vs. 5.69, P =0.00108). Regression analysis adjusting for VAS pain scores showed higher PSEQ-2 was independently associated with remaining nonoperative (OR=0.917; 95% CI[0.841, 0.997]).
CONCLUSION: Higher pain self-efficacy, independent of pain level, was associated with a lower likelihood of undergoing spine surgery, suggesting that a patient's perception of their ability to manage their symptoms factors into the choice to undergo surgery. These findings highlight the importance of psychosocial factors, such as pain self-efficacy, in surgical decision-making and may inform patient counseling strategies.