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Abstract：
Pain self-efficacy, or the belief that one can carry out activities despite pain, has been shown to be associated with back and neck pain severity. However, the literature correlating psychosocial factors to opioid use, barriers to proper opioid use, and Patient-Reported Outcome Measurement Information System (PROMIS) scores is sparse.
The primary aim of this study was to determine whether pain self-efficacy is associated with daily opioid use in patients presenting for spine surgery. The secondary aim was to determine whether there exists a threshold self-efficacy score that is predictive of daily preoperative opioid use and subsequently to correlate this threshold score with opioid beliefs, disability, resilience, patient activation, and PROMIS scores.
Five hundred seventy-eight elective spine surgery patients (286 females; mean age of 55 years) from a single institution were included in this study.
Retrospective review of prospectively collected data.
PROMIS scores, daily opioid use, opioid beliefs, disability, patient activation, resilience.
Elective spine surgery patients at a single institution completed questionnaires preoperatively. Pain self-efficacy was measured by the Pain Self-Efficacy Questionnaire (PSEQ). Threshold linear regression with Bayesian information criteria was utilized to identify the optimal threshold associated with daily opioid use. Multivariable analysis controlled for age, sex, education, income, and Oswestry Disability Index (ODI) and PROMIS-29, version 2 scores.
Of 578 patients, 100 (17.3%) reported daily opioid use. Threshold regression identified a PSEQ cutoff score of <22 as predictive of daily opioid use. On multivariable logistic regression, patients with a PSEQ score <22 had two times greater odds of being daily opioid users than those with a score ≥22. Further, PSEQ <22 was associated with lower patient activation; increased leg and back pain; higher ODI; higher PROMIS pain, fatigue, depression, and sleep scores; and lower PROMIS physical function and social satisfaction scores (p<.05 for all).
In patients presenting for elective spine surgery, a PSEQ score of <22 is associated with twice the odds of reporting daily opioid use. Further, this threshold is associated with greater pain, disability, fatigue, and depression. A PSEQ score <22 can identify patients at high risk for daily opioid use and can guide targeted rehabilitation to optimize postoperative quality of life.
The primary aim of this study was to determine whether pain self-efficacy is associated with daily opioid use in patients presenting for spine surgery. The secondary aim was to determine whether there exists a threshold self-efficacy score that is predictive of daily preoperative opioid use and subsequently to correlate this threshold score with opioid beliefs, disability, resilience, patient activation, and PROMIS scores.
Five hundred seventy-eight elective spine surgery patients (286 females; mean age of 55 years) from a single institution were included in this study.
Retrospective review of prospectively collected data.
PROMIS scores, daily opioid use, opioid beliefs, disability, patient activation, resilience.
Elective spine surgery patients at a single institution completed questionnaires preoperatively. Pain self-efficacy was measured by the Pain Self-Efficacy Questionnaire (PSEQ). Threshold linear regression with Bayesian information criteria was utilized to identify the optimal threshold associated with daily opioid use. Multivariable analysis controlled for age, sex, education, income, and Oswestry Disability Index (ODI) and PROMIS-29, version 2 scores.
Of 578 patients, 100 (17.3%) reported daily opioid use. Threshold regression identified a PSEQ cutoff score of <22 as predictive of daily opioid use. On multivariable logistic regression, patients with a PSEQ score <22 had two times greater odds of being daily opioid users than those with a score ≥22. Further, PSEQ <22 was associated with lower patient activation; increased leg and back pain; higher ODI; higher PROMIS pain, fatigue, depression, and sleep scores; and lower PROMIS physical function and social satisfaction scores (p<.05 for all).
In patients presenting for elective spine surgery, a PSEQ score of <22 is associated with twice the odds of reporting daily opioid use. Further, this threshold is associated with greater pain, disability, fatigue, and depression. A PSEQ score <22 can identify patients at high risk for daily opioid use and can guide targeted rehabilitation to optimize postoperative quality of life.
摘要：
疼痛自我效能感,或者相信一个人可以在痛苦的情况下进行活动，已被证明与背部和颈部疼痛的严重程度有关。然而,将心理社会因素与阿片类药物使用相关的文献，适当使用阿片类药物的障碍，患者报告的结果测量信息系统(PROMIS)分数很少。
这项研究的主要目的是确定脊柱手术患者的疼痛自我效能感是否与每日阿片类药物的使用有关。次要目的是确定是否存在阈值自我效能评分，可以预测每日术前阿片类药物的使用，并随后将该阈值评分与阿片类药物信念相关联。残疾,弹性，患者激活,和PROMIS分数。
本研究纳入了来自单一机构的578名择期脊柱手术患者（286名女性，平均年龄55岁）。
前瞻性收集数据的回顾性回顾。
PROMIS分数，每日使用阿片类药物，阿片类药物的信念，残疾,患者激活,弹性。
单一机构的择期脊柱手术患者在术前完成问卷调查。通过疼痛自我效能问卷(PSEQ)测量疼痛自我效能。利用贝叶斯信息标准的阈值线性回归来确定与每日阿片类药物使用相关的最佳阈值。多变量分析控制年龄，性别,教育,收入,和Oswestry残疾指数(ODI)和PROMIS-29，版本2得分。
578名患者中,100人（17.3%）报告每日使用阿片类药物。阈值回归确定PSEQ截止评分<22作为每日阿片类药物使用的预测。在多变量逻辑回归中，PSEQ评分<22的患者每日使用阿片类药物的几率是评分≥22的患者的两倍.Further,PSEQ<22与较低的患者激活相关;增加的腿部和背部疼痛;较高的ODI;较高的PROMIS疼痛,疲劳,抑郁症,和睡眠得分；和较低的PROMIS身体功能和社会满意度得分（p<0.05）。
在接受择期脊柱手术的患者中，PSEQ评分<22与报告每日阿片类药物使用的几率的两倍相关。Further,这个阈值与更大的疼痛有关，残疾,疲劳,和抑郁症。PSEQ评分<22可以识别每天使用阿片类药物的高风险患者，并可以指导针对性康复以优化术后生活质量。
这项研究的主要目的是确定脊柱手术患者的疼痛自我效能感是否与每日阿片类药物的使用有关。次要目的是确定是否存在阈值自我效能评分，可以预测每日术前阿片类药物的使用，并随后将该阈值评分与阿片类药物信念相关联。残疾,弹性，患者激活,和PROMIS分数。
本研究纳入了来自单一机构的578名择期脊柱手术患者（286名女性，平均年龄55岁）。
前瞻性收集数据的回顾性回顾。
PROMIS分数，每日使用阿片类药物，阿片类药物的信念，残疾,患者激活,弹性。
单一机构的择期脊柱手术患者在术前完成问卷调查。通过疼痛自我效能问卷(PSEQ)测量疼痛自我效能。利用贝叶斯信息标准的阈值线性回归来确定与每日阿片类药物使用相关的最佳阈值。多变量分析控制年龄，性别,教育,收入,和Oswestry残疾指数(ODI)和PROMIS-29，版本2得分。
578名患者中,100人（17.3%）报告每日使用阿片类药物。阈值回归确定PSEQ截止评分<22作为每日阿片类药物使用的预测。在多变量逻辑回归中，PSEQ评分<22的患者每日使用阿片类药物的几率是评分≥22的患者的两倍.Further,PSEQ<22与较低的患者激活相关;增加的腿部和背部疼痛;较高的ODI;较高的PROMIS疼痛,疲劳,抑郁症,和睡眠得分；和较低的PROMIS身体功能和社会满意度得分（p<0.05）。
在接受择期脊柱手术的患者中，PSEQ评分<22与报告每日阿片类药物使用的几率的两倍相关。Further,这个阈值与更大的疼痛有关，残疾,疲劳,和抑郁症。PSEQ评分<22可以识别每天使用阿片类药物的高风险患者，并可以指导针对性康复以优化术后生活质量。
