Nursing Department, University of Seville, Seville, Spain.
Research Unit, San Juan de Dios Aljarafe Hospital, Bormujos, Spain.
J Adv Nurs. 2021 Aug;77(8):3553-3570. doi: 10.1111/jan.14877. Epub 2021 May 10.
To build and preliminarily validate a Spanish-language instrument to assess the impact that CNCP has on the daily lives of people who suffer from it.
The experience of pain is multifactorial and a correct assessment of it helps to control the intensity of pain. Although there are instruments that evaluate areas on which Chronic Non-Cancer Pain impacts, it would be necessary to include other aspects that scientific literature identifies as relevant.
Instrument and construct cross-sectional study for psychometric validation.
A total of 157 items based on items from validated questionnaires were evaluated by a group of 21 chronic pain experts using Delphi methodology in three evaluation rounds. A final questionnaire of 55 items with a 5-point Likert-type scale was formed. This questionnaire was piloted on a total of 30 patients to assess their understanding of the items and the psychometric validation process was carried out (January to March 2020) on a subsequent sample of 395 people, all of whom attended Pain Units and Primary Care Centres of the Public Health System in Spain.
The PAIN_Integral Scale showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of nine factors that explain 71.02% of the total variance, from 157 to a final total of 36 items. Confirmatory Factor Analysis showing adequate values confirmed this structure. The effect size was used to calculate the cut-off points for the overall scale, setting them at scores of 130 and 135.
This instrument would allow to assess other constructs and dimensions not included in the instruments previously available such as treatment compliance, proactivity, resilience, hopelessness due to pain and pain catastrophizing. However, despite the fact that the preliminary analysis shows good results, it is necessary to continue with its validation process in subsequent studies.
The PAIN_Integral Scale , once the validation process is finished, could be a complete enough instrument to allow a comprehensive healthcare assessment of Chronic Non-Cancer Pain's impact on daily nursing clinical practice and other healthcare professionals.
构建并初步验证一种西班牙语工具，以评估慢性非癌性疼痛对患者日常生活的影响。
疼痛体验是多因素的，对其进行正确评估有助于控制疼痛强度。虽然有评估慢性非癌性疼痛影响的工具，但有必要纳入科学文献认为相关的其他方面。
仪器和结构的横断面研究用于心理测量验证。
根据验证问卷中的项目，共有 157 个项目由一组 21 名慢性疼痛专家使用德尔菲方法进行评估，分三轮评估。形成一个包含 55 个项目的最终问卷，采用 5 级李克特量表。这个问卷在总共 30 名患者中进行了预试验，以评估他们对项目的理解，随后在 2020 年 1 月至 3 月期间对 395 名来自西班牙公共卫生系统疼痛科和初级保健中心的患者进行了心理测量验证过程。
PAIN_Integral 量表的内部一致性得分通过 Cronbach's alpha 测量，得分可接受。探索性因素分析表明，有 9 个因素的结构，解释了 71.02%的总方差，从 157 个项目减少到 36 个项目。验证性因素分析显示，这个结构的适当值证实了这一结构。使用效应大小来计算总体量表的切点，设定为 130 和 135 分。
该工具可以评估以前的工具中没有包含的其他构建和维度，如治疗依从性、主动性、韧性、疼痛引起的绝望和疼痛灾难化。然而，尽管初步分析结果良好，但需要在后续研究中继续进行验证过程。
PAIN_Integral 量表，一旦验证过程完成，就可以成为一个足够完整的工具，允许对慢性非癌性疼痛对日常护理临床实践和其他医疗保健专业人员的影响进行全面的医疗评估。
