Pain Self-Efficacy Questionnaire (PSEQ)

1

Name

First Name

Surname

2

Date

3

Please rate how confident you are that you can do the following things at present, despite the pain. To indicate your answer circle one of the numbers on the scale under each item, where 0 = not at all confident and 6 = completely confident.

Remember, this questionnaire is not asking whether of not you have been doing these things, but rather how confident you are that you can do them at present, despite the pain.

5

Q 2 / 10 I can do most of the household chores (e.g. tidying-up, washing dishes, etc.), despite the pain.* This field is required.0 = Not confident at all 6 = Completely confident

0

1

2

3

4

5

6

Q 3 / 10 I can socialise with my friends or family members as often as I used to do, despite the pain.* This field is required.0 = Not confident at all 6 = Completely confident

0

1

2

3

4

5

6

8

Q 5 / 10 I can do some form of work, despite the pain. (“work” includes housework, paid and unpaid work).* This field is required.0 = Not confident at all 6 = Completely confident

0

1

2

3

4

5

6

9

Q 6 / 10 I can still do many of the things I enjoy doing, such as hobbies or leisure activity, despite pain.* This field is required.0 = Not confident at all 6 = Completely confident

0

1

2

3

4

5

6

14

Score