Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia.
Thrive Physiotherapy, 66 Grande Rue, St. Martin, Guernsey, GY4 6LQ, British Isles.
Scand J Pain. 2020 Oct 25;20(4):673-682. doi: 10.1515/sjpain-2019-0169.
Background and Aims Higher chronic pain acceptance is associated with lower pain and disability. Clinician beliefs are associated with patients' beliefs. This study therefore aimed to develop the Chronic Pain Acceptance Questionnaire for Clinicians (CPAQ-C) to measure clinicians' beliefs regarding the importance of levels of acceptance in patients with chronic pain, and to examine the questionnaire's psychometric properties. Methods Phase one: the CPAQ-C was adapted from the Chronic Pain Acceptance Questionnaire. Data on 162 completed questionnaires were analysed using Rasch analysis. Phase Two: the cohort completed the Healthcare Providers Pain and Impairment Relationship Scale, and the association (Pearson's correlation co-efficient) between these questionnaires examined to assist CPAQ-C validation. Twenty-four participants completed the CPAQ-C one-week later. Test re-test reliability was examined using intraclass correlation co-efficient (2,1) and standard error of measurement. Phase Three: to examine responsiveness 17 clinicians attending a workshop on Acceptance and Commitment Therapy completed the CPAQ-C before and immediately after the workshop, and six-months later. The Skillings Mack test was used to determine whether CPAQ-C scores differed across different timepoints. Results Rasch analysis supported two subscales: activity engagement and pain willingness. Five poorly functioning items were excluded. There was good correlation between the CPAQ-C and Healthcare Providers Pain and Impairment Relationship Scale (-.54). The CPAQ-C demonstrated good reliability (ICC (2,1): .81; standard error of measurement: 4.76). There was significant improvement in CPAQ-C scores following the workshop (p=<.001). Conclusions The CPAQ-C appears a valid, reliable and responsive measure of clinicians' beliefs regarding the importance of levels of acceptance in patients with chronic pain. Implications Where the CPAQ-C reveals that clinicians have low perceived levels of importance regarding acceptance in patients with chronic pain those clinicians may benefit from specific education, however, this requires further examination.
背景与目的 较高的慢性疼痛接受度与较低的疼痛和残疾程度相关。临床医生的信念与患者的信念相关。因此，本研究旨在开发用于临床医生的慢性疼痛接受度问卷（CPAQ-C），以测量临床医生对慢性疼痛患者接受度水平重要性的信念，并检验该问卷的心理测量学特性。 方法 第一阶段：CPAQ-C 是从慢性疼痛接受度问卷改编而来。使用 Rasch 分析对 162 份已完成问卷的数据进行分析。第二阶段：该队列完成了医疗保健提供者疼痛和障碍关系量表，检验这些问卷之间的相关性（Pearson 相关系数），以协助 CPAQ-C 的验证。24 名参与者在一周后完成了 CPAQ-C。使用组内相关系数（2,1）和测量标准误差检验重测信度。第三阶段：为了检验反应性，参加接受和承诺治疗工作坊的 17 名临床医生在工作坊之前、之后即刻以及六个月后完成了 CPAQ-C。使用 Skillings Mack 检验来确定 CPAQ-C 分数是否在不同时间点上有所不同。 结果 Rasch 分析支持两个分量表：活动参与和疼痛意愿。五个表现不佳的项目被排除在外。CPAQ-C 与医疗保健提供者疼痛和障碍关系量表之间存在良好的相关性（-.54）。CPAQ-C 具有良好的可靠性（ICC（2,1）：.81；测量标准误差：4.76）。工作坊后 CPAQ-C 分数有显著改善（p<0.001）。 结论 CPAQ-C 似乎是一种有效、可靠且敏感的测量临床医生对慢性疼痛患者接受度水平重要性的工具。 意义 如果 CPAQ-C 显示临床医生对慢性疼痛患者接受度的重要性感知度较低，那么这些临床医生可能会受益于特定的教育，但是，这需要进一步的研究。
