title: Rasch analysis supports the use of the Pain Self-Efficacy Questionnaire.
abstract: BACKGROUND
  The Pain Self-Efficacy Questionnaire (PSEQ) is used by physical therapists in clinical practice and in research. However, current understanding of the PSEQ's measurement properties is incomplete, and investigators cannot be confident that it provides unbiased information on patient self-efficacy.
  
  
  OBJECTIVE
  The aims of this study were: (1) to investigate the scale properties of the PSEQ using Rasch analysis and (2) to determine whether age, sex, pain intensity, pain duration, and pain-related disability bias function of the PSEQ.
  
  
  METHODS
  This was a retrospective study; data were obtained from 3 existing studies.
  
  
  METHODS
  Data were combined from more than 600 patients with low back pain of varying duration. Rasch analysis was used to evaluate targeting, category ordering, unidimensionality, person fit, internal consistency, and item bias.
  
  
  RESULTS
  There was evidence of adequate category ordering, unidimensionality, and internal consistency of the PSEQ. Importantly, there was no evidence of item bias.
  
  
  CONCLUSIONS
  The PSEQ did not adequately target the sample; instead, it targeted people with lower self-efficacy than this population. Item 7 was hardest for participants to endorse, showing excessive positive misfit to the Rasch model. Response strings of misfitting persons revealed older participants and those reporting high levels of disability.
  
  
  CONCLUSIONS
  The individual items of the PSEQ can be validly summed to provide a score of self-efficacy that is robust to age, sex, pain intensity, pain duration, and disability. Although item 7 is the most problematic, it may provide important clinical information and requires further investigation before its exclusion. Although the PSEQ is commonly used with people with low back pain, of whom the sample in this study was representative, the results suggest it targets patients with lower self-efficacy than that observed in the current sample.
authors.affiliation: F. Di Pietro, BPhys(Hons), Neuroscience Research Australia and Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Flavia
authors.initials: F
authors.lastname: Di Pietro
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Catley
authors.forename: James H
authors.initials: JH
authors.lastname: McAuley
authors.forename: Luke
authors.initials: L
authors.lastname: Parkitny
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maher
authors.forename: Luciola da Cunha Menezes
authors.initials: Lda C
authors.lastname: Costa
authors.forename: Luciana G
authors.initials: LG
authors.lastname: Macedo
authors.forename: Chris M
authors.initials: CM
authors.lastname: Williams
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
mesh_terms: D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D026761:Physical Therapy Specialty; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires