Do Commonly Used Measures of Pain Intensity Only Reflect Pain Intensity in Youths With Bothersome Pain and a Physical Disability? (original) (raw)
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Validity of three rating scales for measuring pain intensity in youths with physical disabilities
European journal of pain (London, England), 2015
There is growing evidence confirming that youths with physical disabilities are at risk for chronic pain. Although many scales for assessing pain intensity exist, it is unclear whether they are all equally suitable for youths. The aim of this study was to address this knowledge gap by comparing the validity of the Numerical Rating Scale (NRS-11), the Wong Baker FACES Pain Rating Scale (FACES), and a 6-point categorical Verbal Rating Scale (VRS-6) for assessing pain intensity among youths (aged 8-20) with physical disabilities. One hundred and thirteen youths (mean age = 14.19 years; SD = 2.9) were interviewed and asked to rate their current pain intensity and recalled (in the past week) worst, least, and average pain with the NRS-11 and the FACES. Participants were also asked to rate their average pain intensity during the past 4 weeks using a VRS-6, and were administered measures assessing pain interference, disability and psychological functioning. Analyses showed that all of the ...
Pain Beliefs and Quality of Life in Young People with Disabilities and Bothersome Pain
The Clinical journal of pain, 2017
Pain beliefs have been hypothesized to play an important role in pediatric pain. However, research examining the associations between pain-related beliefs and measures of function in youths with disabilities is limited. Eighty-four youths (mean age=14.26 y; SD=3.27) with physical disabilities who indicated they also had bothersome pain were interviewed and asked to rate their average pain intensity in the past week, and to complete measures of pain-related beliefs and health-related quality of life. A number of pain beliefs were associated with different physical and psychosocial function domains, although different beliefs appeared to play different roles, depending on the function domain examined. Across all of the health-related quality of life domains studied, a belief that pain is influenced by one's emotions was associated with lower levels of function. No differences were found in pain beliefs related to age. In addition, a small difference in pain beliefs was found for s...
Pain extent and function in youth with physical disabilities
Journal of Pain Research, 2017
Background: The aim of this study was to increase our understanding of the role that spatial qualities of pain (location and extent) play in functioning, among youths with disabilities and chronic pain. Methods: One-hundred and fifteen youths (mean age 14.4 years; SD ±3.3 years) with physical disabilities and chronic pain were interviewed and were asked to provide information about pain locations and their average pain intensity in the past week, and to complete measures of pain interference, psychological function and disability. Most of the participants in this sample were males (56%), Caucasian (68%), and had a cerebral palsy (34%) or muscular dystrophy (25%) problem. Most participants did not report high levels of disability (X =12.7, SD ±9.5, range 0-60) or global pain intensity (X =3.2, SD ±2.4, range 0-10). Results: Pain at more than one body site was experienced by 91% of participants. There were positive associations between pain extent with pain interference (r = 0.30) and disability (r = 0.30), and a negative association with psychological function (r =-0.38), over and above average pain intensity. Additionally, pain intensity in the back (as opposed to other locations) was associated with more pain interference (r = 0.29), whereas pain intensity in the shoulders was associated with less psychological function (r =-0.18), and pain intensity in the bottom or hips was associated with more disability (r = 0.29). Conclusion: The findings support the need to take into account pain extent in the assessment and treatment of youths with physical disabilities and chronic pain, call our attention about the need to identify potential risk factors of pain extent, and develop and evaluate the benefits of treatments that could reduce pain extent and target pain at specific sites.
Defining mild, moderate, and severe pain in young people with physical disabilities
Disability and rehabilitation, 2016
The purpose of this study is to identify the cutoffs that are most suitable for classifying average and worst pain intensity as being mild, moderate, or severe in young people with physical disabilities. Survey study using a convenience sample of 113 young people (mean age = 14.19; SD = 2.9; age range: 8-20) with physical disabilities (namely, spinal cord injury, cerebral palsy, spina bifida, limb deficiency (acquired or congenital), or neuromuscular disease). The findings support a non-linear association between pain intensity and pain interference. In addition, the optimal cutoffs for classifying average and worst pain as mild, moderate, or severe differed. For average pain, the best cutoffs were the following: 0-3 for mild, 4-6 for moderate, and 7-10 for severe pain, whereas the optimal classification for worst pain was 0-4 for mild, 5-6 for moderate, and 7-10 for severe pain. The findings provide important information that may be used to help make decisions regarding pain treatm...
The Development and Preliminary Validation of the Pediatric Survey of Pain Attitudes
American Journal of Physical Medicine & Rehabilitation, 2012
Objective-Biopsychosocial models of pain hypothesize patient attitudes and beliefs about pain play a key role in adjustment to chronic pain. The purpose of this study was to facilitate research testing the utility of biopsychosocial models in youths with physical disabilities by developing and testing the validity of a measure of pain-related beliefs that could be used with younger patients. Design-One hundred and four youths with physical disabilities were administered, via interview, a measure of pain-related beliefs developed for youths with chronic pain-the Pediatric Survey of Pain Attitudes (Peds-SOPA)-and a modified Brief Pain Inventory Pain Interference scale (BPI). Results-Item analyses yielded a 29-item pain belief attribution that assessed seven belief domains. The internal consistency (Cronbach's alpha) of the subscales varied from good to excellent (.67-.92). Pearson correlations between Peds-SOPA and the modified BPI showed moderate associations between pain beliefs and pain interference for the Medical Cure (r = .29), Emotion (r = .27), and Disability (r = .36) scales. Conclusions-The findings indicate the Peds-SOPA scales are reliable, and a subset of the scales is associated with an important pain-related domain (pain interference), providing preliminary support for the validity of the Peds-SOPA scales.
Measurement of self-reported pain intensity in children and adolescents
Journal of Psychosomatic Research, 2010
Acute and chronic pain is a common experience in children and youth. A thorough assessment is fundamental to understand this experience and to assess and monitor treatment responses. The intensity of pain is the parameter most commonly assessed. In this article, we describe the different methods employed to assess pediatric pain intensity and review well-validated and commonly used self-report measures of pain. This review is based on the recent systematic reviews conducted for the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials Consensus Group and the Society of Pediatric Psychology. Amongst the several types of pediatric pain measures, self-report, when available, is regarded as the primary source of information about pain intensity, to be complemented by observation and knowledge of the context. There is a large number of self-report measures of pediatric pain intensity; and there is some agreement that professionals in the clinical and research practice should assess pain intensity using the Pieces of Hurt Tool, the Faces Pain Scale, the Oucher, or Visual Analogue Scales because these measures have shown to have sound psychometric properties and clinical utility. Despite the increased number of age-appropriate self-report measures of pediatric pain intensity over the last years, we report several research gaps and priorities of future research.
Chronic pain prevalence and associated factors in adolescents with and without physical disabilities
Developmental Medicine & Child Neurology, 2018
AIM-Adolescents with physical disabilities may have co-occurring chronic pain, but the prevalence and specific associated factors are unknown. The aims of this study were to determine (1) the prevalence of chronic pain in adolescents with physical disabilities and (2) whether known correlates of chronic pain in the general population are also present in young people both with physical disability and with chronic pain relative to peers. METHOD-We conducted a secondary analysis of cross-sectional nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. Multivariate linear regression analysis was used to identify demographic and psychosocial factors associated with chronic pain. RESULTS-A total of 989 (4.3%) adolescents reported physical disabilities. They had a significantly higher rate of pain (27.2%) compared with able-bodied peers (15.6%, χ 2 =86.3550, p<0.001). There was no significant interaction between physical disability status and chronic pain in relation to depressive symptoms, anxiety, or insomnia. INTERPRETATION-Adolescents with physical disabilities experience chronic pain at a significantly higher rate than able-bodied peers, but the comorbidity of physical disability and chronic pain is not related to depression, anxiety, or insomnia. Evaluation of chronic pain and tailored pain interventions need to be developed for this population.
The Pain Disability Index: psychometric properties
Pain, 1990
This paper reports two studies of chronic pain patients {n = 444) relevant to the psychometric properties of the Pain Disabihty Index (PDI), a self-report inst~ment that has been used to assess the degree to which chronic pain interferes with various daily activities. In the first study, patients with high PDI scores reported more psychological distress (P < O&II), more severe pain characteristics (P < O.OOl), and more restriction of activities (P 4 0.001) than patients with low PDI scores, findings supportive of the construct validity of the measure. Further, a multiple regression showed that a linear combination of 9 variables predicted PDI scores (R = 0.74): time spent in bed, psychosomatic symptoms, stopping activities because of pain, work status, pain duration. usual pain intensity, quality of life, pain extent, and education. This study also showed differences for age and gender on disability. The second study involved 46 patients who had undergone inpatient treatment for their pain conditions. The study revealed modest test-retest reliability for the inst~ment. It also showed the PDI to be associated with the levels of pain behavior exhibited by these patients. The findings of both studies generally support the reliability and validity of the PDI as a brief measure of pain-related disability. Questions regarding its test-retest reliability and lack of association with certain pain behaviors are discussed, as are suggestions for future research.
Psychiatry and Clinical Psychopharmacology, 2017
Objective: Pain is one of the significant physical manifestations leading to disability. When investigating disability due to painful chronic diseases, either the particular effect of pain is not adequately separated from other symptoms of the disease, or only the focus is on the physical component of the pain. Therefore, the role of cognitive and emotional factors on disability has been reversed. But recently, attention is increasingly drawn to the role of cognitive and emotional factors in the pathophysiology and treatment of pain. The purpose of this study is to investigate the validity and reliability of the Turkish version of the Pain Catastrophizing Scale (PCS) evaluating cognitive characteristics of pain and is to reveal the relationship between the severity of pain, cognitive and emotional factors and disability through a model. Methods: The study was conducted with 216 patients with the rheumatologic disease with chronic pain for at least six months. In the validity-reliability analyses, Cronbach's alpha, inter-item and item-total correlations, test-retest correlation, and confirmatory factor analysis were applied. Automatic Thoughts Questionnaire was given for parallel test validity. The effects of the physical, cognitive, and emotional components of the pain on disability were assessed with Brief Symptom Inventory, Visual Analog Scale, PCS, and Pain Disability Index and analyzed with Structural Equation Modelling. Results: Cronbach's alpha for PCS' Turkish form was 0.955. Inter-item and item-total correlation were between 0.488 and 0.848. Intraclass correlation coefficient was 0.830. Confirmatory factor analysis confirmed the three-factor model of PCS. Path model showed that pain-related disability is affected not only by the physical properties of the pain but also by the direct and indirect cognitive and emotional factors. Gender and duration of pain are covariates. Discussion: It is important to determine the severity of pain in the evaluation of pain, but the emotional and cognitive characteristics of the pain should also be in this assessment. Turkish version of the PCS can be used in this evaluation. Our study showed that cognitive and emotional interventions, both directly and indirectly, may be positively reflected in the results of attempts to reduce pain-related disability.