Pain Self-Efficacy Is an Important Quality-of-Life Mediator in Migraine

Pain self-efficacy has been found to have a significant impact on quality of life (QOL) outcomes among patients with migraine, according to the results of a cross-sectional study published in BMC Psychology.

Investigators from the University of Zanjan and Shahid Beheshti University in Iran recruited 326 patients referred to a neurology clinic for migraine in 2021 to assess the relationship between meaning in life, perceived social support, spiritual well-being, and pain catastrophizing and quality of life among patients with migraine. The study participants responded to questionnaires that included the World Health Organization Quality of Life Scale (WHOQOL-BREF), the Meaning in Life Questionnaire (MLQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Spiritual Well-Being Scale (SWBS), the Pain Catastrophizing Scale (PSC), and the Pain Self-Efficacy Questionnaire (PSEQ).

The ages of study participants ranged from 25 to 45 years, they reported an average of 12 (standard deviation [SD], 3.85) headaches per month, mean headache intensity was 5.2 (SD, 2.07) on a 10-point scale, and mean headache duration was 6.14 (SD, 2.30) hours per episode.

Investigators found that QOL was directly affected (R², 0.37) by spiritual well-being (β, 0.18), social support (β, 0.16), pain self-efficacy (β, 0.12), meaning in life (β, 0.11), and pain catastrophizing (β, -0.37). Pain self-efficacy was affected directly (R², 0.13) by social support (β, 0.18), spiritual well-being (β, 0.17), meaning in life (β, 0.12), and pain catastrophizing (β, -0.12).

As the predictors meaning in life, social support, spiritual well-being, and pain catastrophizing had significant direct effects on both QOL and pain self-efficacy, and pain self-efficacy itself has a direct effect on QOL, this indicated that social support (β, 0.022), spiritual well-being (β, 0.021), meaning in life (β, 0.015), and pain catastrophizing (β, -0.015) also had indirect effects on QOL through pain self-efficacy.

The combined direct and indirect effects reveal that the total effect on QOL was strongest for pain catastrophizing (β, -0.39), followed by spiritual well-being (β, 0.20), social support (β, 0.19), and meaning in life (β, 0.12).

This model was well fit (c², 1.08; P =.29).

A major limitation of this study was its cross-sectional design, which did not allow for causal inferences to be made.

These data indicate that among patients with migraine, pain self-efficacy has a direct effect on QOL and mediates the relationship between QOL and other important features such as social support and meaning in life. According to the study authors, “[P]ain perception is a complex phenomenon and has cognitive, emotional, behavioral and motivational dimensions that affect each person differently.”

This article originally appeared on Clinical Pain Advisor