Marianne Uggen Rasmussen

Nurse, PhD
+45 3816 4197
+45 3816 4159

Marianne Uggen Rasmussen graduated as a registered nurse from Stavanger Nursing College in Norway in 1986, and was subsequently employed at Stavanger University Hospital in a gastroenterological ward. After moving to Denmark, Marianne completed her Master’s degree in Public Health, at the University of Copenhagen in 2007, and she was employed by Frederiksberg Hospital afterwards to coordinate and teach in a multi-disciplinary rehabilitation program for patients with Chronic Widespread Pain (CWP) and Fibromyalgia (FM), in the outpatient clinic of chronic pain.

Marianne was employed as a research assistant at the Parker Institute in June 2011, while she worked on her Ph.D.-protocol. She was enrolled as a Ph.D.-student in January 2013 at University of Southern Denmark, and she has been lecturing in disease prevention and health promotion at the bachelor of Medicine since then. Marianne defended her Ph.D-thesis: Self-efficacy and rehabilitation af patients with fibromyalgia, on July 1st. 2016.

The focus of Marianne's PhD was to investigate how perceived pain self-efficacy, (the patients confidence in own ability to perform activities in spite of pain), is affected as a result of multi-disciplinary rehabilitation for patients with CWP and FM. The aims of the project was to develop and validate a Danish version of the Pain Self Efficacy Questionnaire (PSEQ), and to use the Danish version (PSEQ-DK), to evaluate effect on pain self-efficacy after multi -disciplinary rehabilitation in a randomized controlled study. A final aim of the PhD was to conduct a qualitative study to investigate how the rehabilitation can influence the patients’ self-efficacy.

Danish version of the pain self-efficacy questionnaire (PSEQ)






AIMS AND OBJECTIVES: To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness.

BACKGROUND: Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self-efficacy is said to influence and predict adaptive coping behaviours and functioning. However, knowledge is lacking on how rehabilitation programmes may influence self-efficacy and ability to cope, from the patients' perspective.

DESIGN: Grounded theory study of semi-structured focus group interviews.

METHODS: Participants (n = 17) were included in four focus groups that had completed a two-week multidisciplinary rehabilitation programme together. Interviews were conducted four weeks after each group had completed the programme. The analysis was conducted constant comparatively applying open, axial and selective coding.

RESULTS: Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness, experiencing acceptance from others and developing new coping strategies. Thus, patients benefitted from multidisciplinary rehabilitation with stronger self-efficacy and expectations to their future coping. However, limitations in the programme were identified, as the programme was short and intensive with no subsequent follow-up, and social welfare was not sufficiently addressed. Participants also found it difficult to maintain knowledge and were lacking individual sessions with the psychologist and had waited long to receive rehabilitation.

CONCLUSION: Multidisciplinary rehabilitation may advantageously be offered to patients with fibromyalgia. However, earlier action with longer programmes, in which patients' social situation is addressed, comprising individual sessions with the psychologist, with multiple repetitions of the content and follow-up sessions, may further enhance the patients' self-efficacy and coping with their illness.

TidsskriftBBA Clinical
Sider (fra-til)931-945
Antal sider15
StatusUdgivet - apr. 2017

OBJECTIVE: To examine the hypothesis that change in pain self-efficacy is associated with observed and self-reported activity, pain intensity, catastrophizing, and quality of life after multi-disciplinary rehabilitation of fibromyalgia patients.

DESIGN: In-depth analyses of secondary outcomes of a randomized-controlled trial.

SUBJECTS: Women (N = 187) with fibromyalgia.

METHODS: Outcomes were Pain Self-Efficacy, Assessment of Motor and Process Skills (AMPS), SF-36 Physical Function (SF-36-PF), pain intensity, and SF-36 Mental Composite Score (SF-36-MCS) to assess quality of life and pain catastrophizing. Individual and group associations between outcomes were examined.

RESULTS: Individual changes in pain self-efficacy were not associated with changes in observed activity: AMPS motor (rs = 0.08, p = 0.27) and process (rs = 0.12, p = 0.11), not even in those patients with a clinically relevant improvement in observed functioning (38.5%), and only weakly or moderatly with changes in SF-36-PF; (rs = 0.31, p < 0.0001), SF-36-MSC; (rs = 0.41, p < 0.0001), and pain catastrophizing (rs = -0.31, p < 0.0001). No differences in pain self-efficacy were observed between the rehabilitated group and controls (difference: 1.61; 95% CI: -0.84 to 4.06; p = 0.24). However, a subgroup (34%) had a clinically relevant improvement in pain self-efficacy. This group was younger (mean age 41.4 vs. 45.8, p = 0.01), more recently diagnosed (1.8 vs. 2.8 years, p = 0.003), but had an unresolved welfare situation (59% vs. 40%, p = 0.02).

CONCLUSION: The main hypothesis was falsified, as there was no association between pain self-efficacy and actual performance of activity. The relation to functioning may be limited to perceived, cognitive-emotional aspects, as indicated by the weak to moderate correlations to the self-reported measures. Implications for Rehabilitation Improvement in observed activity post multi-disciplinary rehabilitation was not associated with change in pain self-efficacy. Patients performed better after rehabilitation, but did not perceive to have improved their capacity. The relationship between pain self-efficacy and functioning may be limited to cognitive-emotional aspects rather than actual activity. Both observational and self-reported measures should be included in evaluating outcomes of rehabilitation for patients with fibromyalgia.

TidsskriftDisability and rehabilitation
Sider (fra-til)1744-1752
Antal sider9
StatusUdgivet - aug. 2017

”Self‐efficacy and Rehabilitation of Patients with Fibromyalgia”

Rasmussen, M. U., Sjölund, B. H., Rydahl-Hansen, S., Amris, K., Mortensen, E. L. & Danneskiold-Samsøe, B. 2016

Publikation: Bog/antologi/afhandling/rapportPh.d.-afhandlingForskning

StatusUdgivet - 2016
The aim of this study was to translate, culturally adapt and evaluate the psychometric properties of the Pain Self-Efficacy Questionnaire (PSEQ) in a population of patients with fibromyalgia in Denmark. The study sample included 102 patients diagnosed with fibromyalgia referred to a specialist clinic. The PSEQ was translated and adapted to a Danish setting using a standard stepw-ise forward-backward translation procedure, followed by initial testing and focus group interview. Reliability was examined by analysing internal consistency and test-retest agreement. Construct validity was exami-ned by investigating dimensionality, targeting, local independence, category functioning and differential item functioning (DIF). Reliability was high: Cronbach's alpha 0.88, test-retest correlation 0.93, intraclass correlation coefficient (ICC) 0.89 and item-total correlations 0.44-0.70. Factor analyses and item response (IRT) models indicated unidimensionality, and the PSEQ-DK was well targeted to the sample. High interitem correlation was observed between two items, indicating local dependence, and item misfit and DIF were observed for a few items. However, the overall fit of the scale to a single-factor model and IRT models supported acceptable construct validity. The PSEQ-DK showed acceptable psychometric properties and can therefore represent a reliable and valid measure for evaluating self-efficacy in patients with fibromyalgia in Denmark.
TidsskriftScandinavian Journal of Caring Sciences
Sider (fra-til)202-10
StatusUdgivet - apr. 2016