Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia.
BMC Anesthesiol. 2021 Jan 15;21(1):20. doi: 10.1186/s12871-020-01229-x.
The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain management with better patient satisfaction. Previous studies revealed that subscales of "patients' perception of pain management" were unstable cross-culturally. This study aims to evaluate the construct validity of the APS-POQ-R in gynecological postoperative patients with a multi-cultural background using confirmatory factor analysis to allow comparisons among different a priori models at the latent factor level.
Patients aged 18 years old or above and who were scheduled for gynecology surgery were selected. Three different models with a combination of latent factors were based on a priori hypotheses from previous studies. The root-mean-squared error of approximation, comparative fit index, Tucker-Lewis Index, Chi-squared test, and change in Chi-squared statistic given a change in degrees of freedom between models were used to assess the model fit to the present data.
A total of 302 patients completed the questionnaire. The five-factor model which was based on Gordon's study has an acceptable fit for the data and was superior when compared to the one-factor baseline model. Although the four-factor model, which originated from Botti's study, also demonstrates a good model fit, the "perception of care" construct was excluded in this model. The "perception of care" construct is conceptually important as patient-centered care has become the focus of quality improvement of pain service.
The APS-POQ-R is easy to administer and is useful for quality evaluation in postoperative pain management. The present study demonstrates that a five-factor structure of the APS-POQ-R is the best fitting model in our patient sample. The results of this study provide further evidence to support the use of APS-POQ-R as a measurement tool for pain management evaluation in acute postoperative patients with a multi-cultural background.
修订后的美国疼痛学会患者结局问卷（APS-POQ-R）评估了成年人疼痛管理的患者报告质量。验证有效的 APS-POQ-R 对于指导有效的疼痛管理和提高患者满意度至关重要。先前的研究表明，“患者对疼痛管理的感知”亚量表在跨文化方面不稳定。本研究旨在使用验证性因子分析评估 APS-POQ-R 在具有多文化背景的妇科手术后患者中的结构效度，以允许在潜在因子水平上比较不同先验模型。
选择年龄在 18 岁及以上且计划接受妇科手术的患者。根据先前研究的先验假设，三种不同的潜在因素组合模型被采用。使用近似均方根误差、比较拟合指数、塔克-刘易斯指数、卡方检验以及模型之间自由度变化引起的卡方检验统计量变化来评估模型对当前数据的拟合程度。
共有 302 名患者完成了问卷。基于 Gordon 研究的五因素模型对数据具有可接受的拟合度，并且优于单因素基线模型。虽然源自 Botti 研究的四因素模型也表现出良好的模型拟合度，但该模型排除了“护理感知”结构。“护理感知”结构在概念上很重要，因为以患者为中心的护理已成为疼痛服务质量改进的焦点。
APS-POQ-R 易于管理，可用于术后疼痛管理质量评估。本研究表明，在我们的患者样本中，APS-POQ-R 的五因素结构是最佳拟合模型。这项研究的结果为进一步支持使用 APS-POQ-R 作为具有多文化背景的急性术后患者疼痛管理评估的测量工具提供了证据。
