The Non-Avoidant Pacing Scale: Development and Preliminary Validation.

Despite widespread use as a chronic pain management strategy, pacing has been linked with higher levels of pain and disability. A recent meta-analysis found a positive correlation between existing measures of pacing and avoidance, which may partially account for these poorer outcomes. A measure was developed to differentiate pacing from avoidance by emphasizing non-pain-contingent pacing behaviors and nonavoidance of pain. A sample of 283 adults with chronic pain completed the Non-Avoidant Pacing Scale (NAPS) and existing measures of pacing, avoidance, pain, and physical and psychological functioning. Exploratory factor analysis of 10 items (subsample 1, n = 141) suggested two 4-item factors: planned pacing behaviors and pacing through flare ups. Confirmatory factor analysis of 8 items (subsample 2, n = 142) revealed satisfactory fit (goodness-of-fit index .947, comparative fit index .964). The pattern of correlations between each factor and avoidance and key outcomes suggests that the NAPS total scale (ɑ = .819) captures key pacing behaviors and differentiates pacing from avoidance. Unlike existing measures, the NAPS was not positively correlated with avoidance and was associated with better psychological functioning across affective and cognitive domains. The NAPS allows researchers and clinicians to assess the role of pacing in chronic pain management without artefactual overlap with avoidance. PERSPECTIVE: The NAPS assesses activity pacing in chronic pain without artefactual overlap with avoidance. Associations were found between more frequent pacing, as measured by the NAPS, and better psychological functioning. Clearly differentiating pacing from avoidance allows for accurate assessment of the role of pacing in chronic pain management.