Early Self-Efficacy Predicts Short- and Long-Term Pain and Functional Outcomes Following Surgically Treated Lower...

This study aimed to identify which early psychosocial measures are most predictive of pain severity, pain interference, physical function, and chronic pain throughout recovery from lower extremity fractures (LEF).

Prospective cohort study.

Level 1 trauma center.

A total of 240 patients (43±15y) with acute LEF.

Not applicable.

In this prospective cohort study, 240 adults with surgically treated LEFs completed psychosocial questionnaires 6 weeks after surgery. Pain severity, pain interference, and physical function outcomes were assessed longitudinally at 3, 6, 12, and 24 months, and the outcome of chronic pain at 12 and 24 months each using validated patient-reported outcome measures. Hierarchical regression analyses examined the predictive value of early psychosocial factors on outcomes over time.

A total of 163 participants (67%) completed the study through 24 months. Pain catastrophizing was associated with pain interference across all time points through 24 months (P≤.049), whereas self-efficacy was associated at 3, 6, and 24 months (P≤.002). Self-efficacy was consistently associated with physical function across follow-up (P≤.01). Pain catastrophizing and self-efficacy were associated with chronic pain at 12 months (P≤.04), with self-efficacy remaining associated with chronic pain at 24 months (P=.017).

Although early pain catastrophizing and self-efficacy were associated with pain and disability-related outcomes throughout 24 months of recovery from a LEF, pain self-efficacy was most consistently associated with each outcome. Early assessment of self-efficacy may provide useful prognostic information regarding pain and functional outcomes following LEF.