慢性疼痛接纳问卷：意大利慢性腰痛患者的验证性因子分析、信度和效度。

Chronic pain acceptance questionnaire: confirmatory factor analysis, reliability, and validity in Italian subjects with chronic low back pain.

机构信息

Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Institute of Care and Research, Salvatore Maugeri Foundation, IRCCS, Lissone, Milan, Italy.

出版信息

Spine (Phila Pa 1976). 2013 Jun 1;38(13):E824-31. doi: 10.1097/BRS.0b013e3182917299.

DOI:10.1097/BRS.0b013e3182917299

PMID:23524871

Abstract

STUDY DESIGN

Cross-sectional evaluation of the psychometric properties of a translated questionnaire.

OBJECTIVE

To validate the Italian version of the Chronic Pain Acceptance Questionnaire (CPAQ) to allow its use with Italian-speaking patients with chronic low back pain (LBP).

SUMMARY OF BACKGROUND DATA

Growing attention is being given to cognitive-behavioral measures to improve interventions for LBP. The CPAQ has never been validated in Italian subjects with chronic LBP.

METHODS

The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach α), test-retest reliability (intraclass correlation coefficient), sensitivity to change by calculating the smallest detectable change, and construct validity by comparing CPAQ with a pain numerical rating scale, the Roland-Morris Disability Questionnaire Scale, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale, and the Tampa Scale of Kinesiophobia (Pearson correlations). Hierarchical multiple regression analyses were computed to further investigate construct validity of the CPAQ subscales.

RESULTS

The questionnaire was administered to 142 subjects with chronic LBP. Factor analysis confirmed a 2-factor (viz., Activities Engagement and Pain Willingness) 20-item solution, achieving a good data-model fit. Internal consistency (α = 0.88) and test-retest reliability (intraclass correlation coefficient = 0.86) were good. The smallest detectable change was 22. Construct validity showed a moderate correlation between the CPAQ and numerical rating scale (r = -0.485), Roland-Morris Disability Questionnaire Scale (r = -0.594), and Tampa Scale of Kinesiophobia (r = -0.595), and a close correlation with Hospital Anxiety and Depression Scale (r = -0.610 for the Anxiety score and r = -0.659 for the Depression score) and Pain Catastrophizing Scale (r = -0.658). The standardized regression coefficients for Activity Engagement were significant in all of the equations, and those for Pain Willingness were significant in the anxiety, depression, and disability equations.

CONCLUSION

The Italian CPAQ had a good factorial structure and psychometric properties that replicated the results of other versions. Its use is recommended for clinical and research purposes.

LEVEL OF EVIDENCE

摘要

研究设计

经过翻译的问卷的心理计量特性的横截面评估。

目的

验证意大利版慢性疼痛接受问卷（CPAQ），以允许其用于意大利语慢性腰痛（LBP）患者。

背景资料概要

人们越来越关注认知行为措施，以改善 LBP 的干预措施。CPAQ 从未在意大利慢性 LBP 患者中得到验证。

方法

心理计量测试包括验证性因素分析、内部一致性（Cronbach α）的可靠性、测试-再测试可靠性（组内相关系数）、通过计算最小可检测变化来测量变化的敏感性、通过将 CPAQ 与疼痛数字评分量表、罗伦兹-莫里斯残疾问卷量表、医院焦虑抑郁量表、疼痛灾难化量表和坦帕运动恐惧症量表（Pearson 相关）进行比较来评估结构效度。进行层次多元回归分析，以进一步探讨 CPAQ 分量表的结构效度。

结果

该问卷共纳入 142 例慢性 LBP 患者。因子分析证实了一个 2 因素（即活动参与度和疼痛意愿度）20 项解决方案，数据模型拟合度良好。内部一致性（α=0.88）和测试-再测试可靠性（组内相关系数=0.86）良好。最小可检测变化为 22。结构效度显示 CPAQ 与数字评分量表（r=-0.485）、罗伦兹-莫里斯残疾问卷量表（r=-0.594）和坦帕运动恐惧症量表（r=-0.595）呈中度相关，与医院焦虑抑郁量表（焦虑评分的 r=-0.610 和抑郁评分的 r=-0.659）和疼痛灾难化量表（r=-0.658）呈密切相关。活动参与度的标准化回归系数在所有方程中均有统计学意义，疼痛意愿度的标准化回归系数在焦虑、抑郁和残疾方程中均有统计学意义。