Levels of activation for self-management of health in patients with chronic shoulder pain

• Grant number: 25/03675-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2025
• End date: June 30, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Anamaria Siriani de Oliveira
• Grantee: Bianca Okuha Pires
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Musculoskeletal pain is a complex condition resulting from the interaction of structural, psychosocial, and lifestyle factors, challenging symptom management, adherence to exercises, and the maintenance of physical activity for individuals. In this scenario, understanding factors that contribute to the explanation and adoption of behavior favorable to physical activity can facilitate the promotion of strategies for maintaining benefits acquired through rehabilitation. Among these factors, activation for health self-management and self-efficacy are highlighted. However, there is still a gap in the understanding of activation for health self-management in individuals with chronic shoulder pain. Therefore, this study aims to identify activation levels in individuals with chronic shoulder pain and investigate the factors associated with these levels. The study sample will consist of 80 individuals of both genders, aged 18 and above, with a diagnostic hypothesis of clinical problems related to complaints of shoulder pain and dysfunction from the Physical Therapy Service of the Prof. Dr. Joel Domingos Machado-Sumarezinho School Health Center of the School of Medicine of Ribeirão Preto at the University of São Paulo and the Hospital das Clínicas of Ribeirão Preto. The assessment will include the completion of the Patient Activation Measure (PAM-13) to measure the level of activation for health self-management, the Pain Self-Efficacy Questionnaire (PSEQ-10) to assess self-efficacy, the Shoulder Pain and Disability Index (SPADI) to evaluate shoulder pain and disability, and the Visual Numeric Scale (VNS) to assess pain intensity. Multiple Linear Regression will be used to investigate the association of self-efficacy and shoulder pain and disability with self-health activation using the backward method. This analysis will also include sociodemographic and clinical factors that show potential association with self-health activation in a simple linear regression model, only for the control of mediating factors. It is expected to find individuals with average levels of self-health management activation, as well as low levels of self-health management activation in individuals with high levels of pain and disability, as well as some level of association of self-health management activation with some of the sociodemographic and clinical factors. (AU)