The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

Figures & data

Table 1. Patient characteristics.

Characteristic	Percent or Mean ± SD (range)
Men	58.4%
Age (years)	59.12 ± 10.25 (28-89)
Caucasian	94.9%
Family History of ALS	6.6%
–ALSFRS-R Total Score	31.29 ± 9.44
Disease Duration (years)	3.8 ± 3.31 (0-19.43)
Site of onset	Upper Extremity = 37.8%
	Lower Extremity = 38.8%
	Bulbar = 12.8%
	Generalized = 5.1%
	Respiratory = 3.1%
	Unsure = 2.6%
Riluzole Use	49.8%
Feeding Tube	14.7%
Non-invasive ventilation	27.4%
Tracheotomy/Mechanical  Ventilation	2.5%

ALSFRS-R: ALS Functional Rating Scale-Revised.

Figure 1. Pain relief. Patients were asked to rate the amount of relief that pain medications or treatments have provided in the past 24 h, ranging from 0% (no relief) to 100% (complete relief). Nearly a quarter obtained no relief from their pain.

Table II. Pain features and management.

Pain characteristics or management	Mean ± SD (range) or percent
Brief Pain Inventory*
Pain at its worst	5.03 ± 2.61 (0-10)
Pain at its least	1.62 ± 2.06 (0-10)
Pain on average	3.28 ± 2.0 (0-10)
Pain right now	3.17 ± 2.16 (0-10)
Pain Interference	3.35 ± 2.76 (0-10)
Pain Relief from treatments	48 ± 35.6 (0-100)
Clinician Managing Pain
Neurologist	39.9%
Primary Care Physician	13.3%
Pain Management Specialist	2.9%
Hospice	4.6%
Palliative Care	2.9%
No One Manages Pain	28.9%
Other	7.5%

* Pain 0 (no pain) to 10 (pain as bad as it can be). Pain interference 0 (does not interfere) to 10 (interferes completely). Pain relief 0% (no relief) to 100% (complete relief).

Table III. Descriptive statistics of depression, anxiety and self-efficacy.

Measure	Mean ± SD (range) or n (%)
HADS Depression Score	8.30 ± 2.70 (3–16)
HADS Depression Severity
0–7 (No)	92 (46.7)
8–10 (Borderline)	57 (28.8)
11–21 (Yes)	48 (24.5)
HADS Anxiety Score	6.92 ± 3.94 (0–19)
HADS Anxiety Severity
0–7 (No)	114 (58.1)
8–10 (Borderline)	47 (23.7)
11–21 (Yes)	36 (18.3)
Pain self-efficacy Score	51.84 ± 24.46 (10–100)
Coping self-efficacy Score	53.71 ± 22.69 (10–100)

HADS: Hospital Anxiety and Depression Scale.

Table IV. Correlations of depression, anxiety, self-efficacy, and pain.

	Average pain severity	Pain Interference	Pain relief	Depression	Anxiety
Depression	0.24*	0.28*	NS
Anxiety	0.35*	0.39*	NS
Pain self-efficacy	−0.46*	−0.53*	0.29*	NS	−0.51*
Coping self-efficacy	−0.41*	−0.54*	0.14*	−0.33*	−0.70*

* p < 0.001

Table V. Pain severity, interference, and relief: multiple linear regression.

	Multivariable
	Pain severity		Pain interference		Pain relief
Variable	Parameter estimate	p-value	Parameter estimate	p-value	Parameter estimate	p-value
HADS Depression	0.09910	0.10	0.16930	0.03*	0.23456	0.85
HADS Anxiety	0.06395	0.22	0.04111	0.54	0.06711	0.95
Pain Self-Efficacy	−0.03456	<0.001**	−0.03693	0.001**	0.52025	0.001**
Coping Self-Efficacy	0.00418	0.67	−0.02250	0.07	0.02303	0.91
Age (years)	−0.01245	0.36	−0.06354	0.001**	0.05020	0.86
Gender (M, F)	0.68672	0.02*	0.02281	0.95	19.18642	0.001**
Disease Duration (years)	−0.04627	0.27	−0.00008	0.99	−0.47242	0.57
ALSFRS-R Total Score	−0.01671	0.34	−0.03149	0.16	−0.69128	0.05

* p < 0.05

** p ≤ 0.001

R-Square = 0.32 (severity), 0.43 (interference), 0.21 (relief). ALSFRS-R: S Functional Rating Scale-Revised; HADS: Hospital Anxiety and Depression Scale.