Sturgeon John, Seward Joshua, Rumble Deanna, Trost Zina
Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Eur J Pain. 2021 Mar;25(3):668-679. doi: 10.1002/ejp.1702. Epub 2020 Dec 14.
Patterns of cognitive appraisal related to chronic pain may manifest differentially across time due to a variety of factors, but variability of injustice appraisals across time has not been examined. The current study details the validation of a brief, daily version of the Injustice Experience Questionnaire (IEQ), which measures injustice appraisals related to the experience of pain and disability.
Injustice Experience Questionnaire items were adapted for daily use and evaluated using cognitive interviews, and the resulting measure was administered for 10 days to two Internet-based samples of US adults with chronic lower back pain.
Study 1 (N = 126) refined the 12-item IEQ measure into a six-item short form; exploratory factor analyses suggested optimal model fit for the two-factor model established in the original IEQ. Using confirmatory factor analyses, Study 2 (N = 131) replicated the two-factor structure and demonstrated significant correlations of the Daily IEQ with other relevant constructs to chronic pain, such as pain catastrophizing, pain intensity, pain-related activity and social interference, depressed mood and anxiety. Daily IEQ items showed a significant degree of clustering (intraclass correlations ranging from .577 to .735) but demonstrated sufficient variability at the daily level to allow for daily-level analysis.
Injustice appraisals show a sufficient degree of daily variability to warrant their measurement as a time-varying construct. Further examination of antecedents and correlates of daily injustice appraisals, as well as their potential role as mechanisms of effect, may better explain the dynamics of affective and behavioral responses to chronic pain.
The current study presents a validation of a daily version of the Injustice Experience Questionnaire in chronic low back pain. Results indicate that injustice appraisals vary significantly from day to day, and daily variability in injustice perception shows robust associations with pain intensity, pain-related interference in physical and social activity, and mood in chronic low back pain. These results emphasize the importance of assessing injustice perception as a time-varying, rather than stable construct in future empirical and clinical studies.
由于多种因素，与慢性疼痛相关的认知评估模式可能随时间表现出差异，但尚未研究不公正评估随时间的变异性。本研究详细介绍了一份简短的、每日使用的不公正体验问卷（IEQ）的验证情况，该问卷用于测量与疼痛和残疾体验相关的不公正评估。
对不公正体验问卷的项目进行改编以便每日使用，并通过认知访谈进行评估，随后将生成的量表对两个患有慢性下背痛的美国成年互联网样本进行了为期10天的施测。
研究1（N = 126）将12项IEQ量表精炼为一个6项的简短形式；探索性因素分析表明，最优模型适合原始IEQ中建立的双因素模型。使用验证性因素分析，研究2（N = 131）复制了双因素结构，并证明每日IEQ与慢性疼痛的其他相关构念存在显著相关性，如疼痛灾难化、疼痛强度、与疼痛相关的活动和社会干扰、抑郁情绪和焦虑。每日IEQ项目显示出显著程度的聚类（组内相关系数范围为0.577至0.735），但在每日水平上表现出足够的变异性，以便进行每日水平的分析。
不公正评估在每日水平上表现出足够的变异性，足以将其作为一个随时间变化的构念进行测量。进一步研究每日不公正评估的前因和相关因素，以及它们作为影响机制的潜在作用，可能会更好地解释对慢性疼痛的情感和行为反应的动态变化。
本研究对慢性下背痛患者每日使用的不公正体验问卷进行了验证。结果表明，不公正评估在每日之间存在显著差异，不公正感知的每日变异性与疼痛强度、身体和社会活动中与疼痛相关的干扰以及慢性下背痛患者的情绪存在密切关联。这些结果强调了在未来的实证和临床研究中，将不公正感知评估为一个随时间变化而非稳定的构念的重要性。
