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.”
Afrashteh MY, Abbasi M, Abbasi M. The relationship between meaning of life, perceived social support, spiritual well‑being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self‑efficacy. BMC Psychol. Published online January 23, 2023. doi:10.1186/s40359-023-01053-1