Does Pain Self-efficacy Moderate the Association of Psychosocial Factors With the Health-related Quality of Life of Patients Scheduled for Lumbar Spine Surgery?

OBJECTIVES

This study aimed to investigate the moderating role of pain self-efficacy (SE) 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, 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 SE on these relationships.

RESULTS

The final model explained 43.8% of the HRQOL variance. Significant interactions were noted between pain SE 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 SE group.

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