Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada.
Pain. 2011 Sep;152(9):1958-1965. doi: 10.1016/j.pain.2011.02.053. Epub 2011 Apr 12.
Pain anxiety refers to the cognitive, emotional, physiological, and behavioural reactions to the experience or anticipation of pain. The Child Pain Anxiety Symptoms Scale (CPASS) has recently been developed and validated in a pediatric community sample. The goal of the present study was to examine the psychometric properties of the CPASS in a sample of children and adolescents with acute postsurgical pain. Eightythree children aged 8–18 years (mean 13.8 years, SD 2.4) completed measures of pain anxiety, anxiety sensitivity, pain catastrophizing, anxiety, depression, and pain intensity and unpleasantness 48–72 hours after major surgery; and pain intensity and unpleasantness, pain anxiety, and functional disability approximately 2 weeks after discharge from the hospital. The CPASS showed excellent internal consistency (a = 0.915). Stronger partial correlations of pain anxiety with anxiety sensitivity (r = 0.70) and pain catastrophizing (r = 0.73) compared to pain anxiety with anxiety (r = 0.53) and depression (r = 0.59) suggest excellent construct validity. Pain anxiety was significantly associated with pain intensity (r = 0.44) and unpleasantness (r = 0.32) 48–72 hours after surgery (concurrent validity) and with pain unpleasantness (r = 0.29) and functional disability (r = 0.50; but not pain intensity, r = 0.20) 2 weeks later (predictive validity). The CPASS showed adequate sensitivity to change over time (mean change = 9.52; effect size = 0.49) and good sensitivity and specificity. The results of the present study provide initial validity and reliability of the CPASS in a clinical sample of children and adolescents after major surgery.
疼痛焦虑是指对疼痛经历或预期的认知、情绪、生理和行为反应。儿童疼痛焦虑症状量表（CPASS）最近在儿科社区样本中得到了开发和验证。本研究的目的是在接受大手术后急性疼痛的儿童和青少年样本中检验 CPASS 的心理测量特性。83 名 8-18 岁的儿童（平均年龄 13.8 岁，SD=2.4）在大手术后 48-72 小时内完成了疼痛焦虑、焦虑敏感性、疼痛灾难化、焦虑、抑郁、疼痛强度和不愉快度的测量，以及在出院后约 2 周内完成了疼痛强度和不愉快度、疼痛焦虑和功能障碍的测量。CPASS 表现出极好的内部一致性（a=0.915）。疼痛焦虑与焦虑敏感性（r=0.70）和疼痛灾难化（r=0.73）的偏相关系数明显强于与焦虑（r=0.53）和抑郁（r=0.59）的偏相关系数，这表明其具有极好的结构效度。疼痛焦虑与术后 48-72 小时的疼痛强度（r=0.44）和不愉快度（r=0.32）显著相关（同时效度），与 2 周后的疼痛不愉快度（r=0.29）和功能障碍（r=0.50；但与疼痛强度无关，r=0.20）显著相关（预测效度）。CPASS 显示出随时间变化的适度敏感性（平均变化=9.52；效应量=0.49）和良好的敏感性和特异性。本研究的结果为 CPASS 在接受大手术后的儿童和青少年临床样本中的初步有效性和可靠性提供了证据。
