Bath Centre for Pain Services, Royal United Hospitals Bath, Royal National Hospital for Rheumatic Diseases.
Faculty for Health and Applied Sciences, University of the West of England.
J Pediatr Psychol. 2019 May 1;44(4):453-462. doi: 10.1093/jpepsy/jsy090.
Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain. This variable has been previously measured using the Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A, McCracken, Gauntlett-Gilbert, & Eccleston, European Journal of Pain, 14, 316-320, 2010). We set out to create a short, eight-item, form of this instrument that retained its factor structure and clinical utility.
We used data collected from two independent samples of adolescents attending residential treatment for disabling chronic pain (N = 187 and N = 159). Both groups completed the 20-item CPAQ-A and indices of functioning and distress. We carried out item reduction and confirmatory factor analysis (CFA) on the first sample, repeating this on the second sample and examining the new scale's correlations with clinically relevant variables.
An eight-item scale was created with four items assigned to each established factor (Pain Willingness and Activity Engagement). CFA confirmed this factor structure and it replicated in Sample 2. The new scale (the CPAQ-A8) was sensitive to treatment and correlated as well with clinically important variables as its full-length version. Some items in the new scale differed from the adult CPAQ-8.
Measures of pain acceptance have been previously developed and validated in pediatric and adult samples. This study showed that pain acceptance can be indexed by a brief, yet factorially valid, short form of the CPAQ-A that uses fewer than 50% of the items of the full-length scale and has demonstrated acceptable validity and sensitivity-to-treatment.
疼痛的接受程度是预测青少年疼痛相关残疾和治疗结果的一个指标。该变量以前使用青少年慢性疼痛接受问卷（CPAQ-A，McCracken，Gauntlett-Gilbert 和 Eccleston，《欧洲疼痛杂志》，14，316-320，2010）进行过测量。我们旨在创建一个简短的、包含 8 个项目的该工具的简化版本，保留其结构和临床实用性。
我们使用来自参加住宿治疗的青少年（残疾性慢性疼痛）的两个独立样本的数据（N=187 和 N=159）。两组都完成了 20 项 CPAQ-A 以及功能和痛苦指数。我们在第一个样本中进行项目缩减和验证性因素分析（CFA），在第二个样本中重复此过程，并检查新量表与临床相关变量的相关性。
创建了一个包含 8 个项目的量表，其中 4 个项目分配给每个已建立的因子（疼痛意愿和活动参与）。CFA 证实了该结构，并且在样本 2 中得到了复制。新量表（CPAQ-A8）对治疗敏感，与临床重要变量的相关性与完整版本相当。新量表中的某些项目与成人 CPAQ-8 不同。
之前已经在儿科和成人样本中开发和验证了疼痛接受程度的测量方法。本研究表明，疼痛接受程度可以通过 CPAQ-A 的简短但具有因子有效性的简化形式来衡量，该形式使用不到完整量表项目的 50%，并且具有可接受的有效性和对治疗的敏感性。
