The relationship between work self-efficacy and work participation in employees with chronic pain: Analysis of cross-sectional data from the Pain-at-Work trial.

ObjectiveWork participation among employees with chronic pain is influenced by psychological, clinical, and workplace factors. Self-efficacy is a potentially modifiable attribute; however, its role in presenteeism remains underexplored. This study examined the association between work-related self-efficacy and work participation, with a primary focus on presenteeism, among employees living with chronic pain.MethodsWe analyzed cross-sectional baseline data of 280 employed adults with chronic pain participating in the Pain-at-Work trial in England. Two work-specific self-efficacy items assessed confidence in managing pain at work and confidence that working would not worsen their condition. Work participation was measured using presenteeism scores of the Work Productivity and Activity Impairment Questionnaire, which was the primary outcome analyzed in multivariable linear regression models. Models were adjusted for pain severity, mood (assessed using the Patient Health Questionnaire 2 and Generalized Anxiety Disorder 7 scale), workplace social support, age, and sex.ResultsLower work self-efficacy was significantly associated with higher presenteeism. Confidence in managing pain at work showed the strongest association (β = -2.70, 95% confidence interval: -3.98 to -1.43; p < 0.001), while confidence that working would not exacerbate pain was also independently associated with lower presenteeism (β = -1.41, 95% confidence interval: -2.43 to -0.39; p = 0.007). Pain severity remained a strong independent predictor of presenteeism. Mood, workplace social support, and sex were not significant predictors.ConclusionHigher work self-efficacy is associated with lower presenteeism among employees with chronic pain, independent of pain severity and psychological distress. Confidence in managing symptoms at work appeared to be a strong influential factor. These findings are clinically relevant for the management of working-age patients with chronic pain, highlighting the importance of addressing both pain control and work-related confidence along with organizational strategies that enable employees to implement self-management skills.