Outcome Measure

Pain Self-Efficacy Questionnaire

What it measures?

  • The beliefs held by people experiencing chronic pain that they can carry out certain activities even when experiencing pain.

Who is it for?

Adults aged 18 years +

Instrument Quality

  • The PSEQ is widely used and recommended for use in multidisciplinary pain programs. A systematic review confirmed that the PSEQ possesses good construct validity and correlates negatively with measures of disability, pain interference, anxiety, depression and catastrophising (Dube, Roy & Langevin, 2021).


  • 10 items
  • 7-point Likert scale
  • Respondents are asked to read 10 statements and rate how confident that they are in being able to do the activity (0 = "Not at all confident"; 6 = "Completely confident") reflected in each statement (e.g. “I can enjoy things despite pain”)

Scoring instructions

Sum all item responses to derive a full-scale score

Subscale Item number

Full-scale (PSEQ)


Score Interpretation

What higher scores mean?
  • Higher scores are desirable and indicate higher levels of confidence to perform activities despite pain (i.e. pain self-efficacy)
How to assess symptom severity & change?
Description Score Range  
Severe 0  
Moderate 20  
Mild 31  
Minimal 41  
Severity ranges

Cutoff values and labels (minimal, mild, moderate, severe) recommended in reference manual for the Electronic Persistent Pain Outcomes Collaboration (ePPOC)

Reliable change and clinically significant improvement

A systematic review evaluated four studies and calculated a weighted mean for the Standard Error of Measurement (Dubé, Langevin & Roy, 2021). The minimal detectable change with a 95% confidence interval was 11.52 out of 60 points (range 3.41-11.52). The reference manual for the Electronic Persistent Pain Outcomes Collaboration (ePPOC) recommends that clinically significant change is indicated where there is a change of 7 or more points, coupled with a move to a different level of impairment.

Value Comments
0.86 A systematic review evaluated the Intra Class Correlation (ICC) across 11 studies, using the COSMIN criteria (Dubé, Langevin & Roy, 2021). The range of ICC coefficients was 0.75-0.93, with an overall weighted mean of 0.86

Instrument developers

  • Nicholas MK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain. 2007 Feb;11(2):153-63. doi: 10.1016/j.ejpain.2005.12.008. Epub 2006 Jan 30. PMID: 16446108


* Dubé MO, Langevin P, Roy JS. Measurement properties of the Pain Self-Efficacy Questionnaire in populations with musculoskeletal disorders: a systematic review. Pain Rep. 2021 Dec 21;6(4):e972. doi: 10.1097/PR9.0000000000000972. PMID: 34963996; PMCID: PMC8701870 * Nicholas MK, Costa DSJ, Blanchard M, Tardif H, Asghari A, Blyth FM. Normative data for common pain measures in chronic pain clinic populations: closing a gap for clinicians and researchers. Pain. 2019 May;160(5):1156-1165. doi: 10.1097/j.pain.0000000000001496. PMID: 30694928.

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