Background and Aim: Pain affects different domains in patients’ daily living. Accordingly, the success of pain therapy can be measured via different variables. During the last decades, patients’ perceptions of their pain becomes more and more significant. Currently, there are no recommendations regarding to the standardized use of patient-reported outcome measures (PROMs) in the field of acute postoperative pain therapy. A current project – Providing Standardized Consented PROMs for Improving Pain Treatment (PROMPT) within IMI Pain care (see www.imi-paincare.eu) deals with identification of a core set of PROMs for acute pain after surgery. According to a consensus expert group within this project, self efficacy is an important PROM to evaluate acute postoperative pain management by default. Self efficacy is defined as the extent or strength of one's belief in one's own ability to complete tasks and reach goals [1]. Respectively, a definition of pain-related self efficacy after surgery was adapted, indeed “the extent or strength of one's belief in one's own ability to complete tasks while experiencing acute postoperative pain”. Given that the choice of suitable instruments is crucial [2], the aim of this systematic literature review was to systematically search for an appropriate PROM to assess self-efficacy in the acute situation after surgery among the currently existing options.
Methods: A systematic literature review was performed for the domain “self-efficacy” in validation, scale development or similar studies via MEDLINE, PsychInfo and Embase. Similar or overlapping constructs were considered in order to ensure comprehensive search results. Search terms were self efficacy, self management, resilience and locus of control. We included only articles in English and German published in journals with available full text and specified the search for humans, concretely adults. Two independent searchers screened title and abstracts, reviewed full texts and extracted information from the studies.
Results: The systematic search identified 2010 potentially relevant studies. Finally, 921 studies were included after title abstract screening. Among these, 239 trials focused on general or disease specific self-efficacy and were included. There were more than 70 different specific settings or conditions (e.g. mental illness, exercise, cancer etc.). 21 categories were relevant. However, no specific scale for acute postoperative pain or similar conditions was identified.
Conclusions
There are various possibilities to assess self-efficacy in general or within specific health-related settings/conditions. Recommended scales base on the general model of Bandura (definition of general self-efficacy). No PROM was identified to assess pain-related self-efficacy specially suitable for the acute situation after surgery. There are only few self-efficacy PROMs related to chronic pain. Due to these results, we are currently realizing a further review on the assessment of pain-related self-efficacy using a slightly different search strategy.

This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No [777500]. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. www.imi.europa.eu; www.imi-paincare.eu 
The statements and opinions presented here reflect the author's view and neither IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained therein.

[1] Bandura, A. (1993). Perceived self-efficacy in cognitive development and functioning. Educational Psychologist, 28(2), 117-148.
[2] Mokkink L.B. et al. (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: An international Delphi study. Qual Life Res.,19(4) 539-549.

ASSESSING PAIN-RELATED SELF-EFFICACY AFTER SURGERY AS A PATIENT-RELATED OUTCOME MEASURE - A SYSTEMATIC LITERATURE REVIEW