Toccaceli Virgilia, Tenti Michael, Stazi Maria Antonietta, Fagnani Corrado, Medda Emanuela, Gargiulo Lidia, Burgio Alessandra, Sampaolo Letizia, Ferri Maurizio, Raffaeli William
Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy.
Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy.
J Pain Res. 2022 Jul 8;15:1897-1913. doi: 10.2147/JPR.S362510. eCollection 2022.
Chronic pain (CP) prevalence estimates addressing a wide phenotype are still quite fragmented and may vary widely due to the lack of standardized tools of investigation. There is an urgent need to update general population CP estimates.
For this purpose, the Brief Five-item Chronic Pain Questionnaire was developed through experts' consultations for design and content validity assessment; literature analysis of measures used to investigate CP for general population surveys; understandability evaluation through a survey on a convenience sample of affected and non-affected individuals; reliability assessment by means of two double-wave online surveys carried out by the Italian Twin Registry; criterion and construct validity assessment through the third wave of the 2019 European Health Interview Survey (Ehis).
Key dimensions were defined to describe CP main aspects from a public health perspective. Literature analysis showed that validated questionnaires were rarely used to address important public health CP aspects. Understandability of the measure was good. Test-retest analyses showed adequate reliability of the measure: k values were at least "moderate" with highest values regarding CP "occurrence" and "intensity". Correlations of CP with well-known comorbidities (cancer, depression), and specific traits (age, education) as well as of CP and its intensity with "physical pain occurrence and intensity" detected in the Ehis 2019, confirmed, respectively, a good construct and criterion validity. Construct validity was also evaluated through the correlation between "perceived treatment effectiveness" and "interference of pain in daily life activities" as recorded in the Ehis 2019.
The designed questionnaire is a brief self-administered measure, particularly suitable to detect persistent states of pain and related intensity in large-scale general population surveys by means of a first filtering item followed by four further items. It is, in fact, designed to detect CP possible underlying causes/triggers, drugs/treatments taking and frequency, and self-perceived effectiveness among CP sufferers. Further validation of the measure in different social and cultural contexts is desirable.
针对广泛表型的慢性疼痛（CP）患病率估计仍然相当零散，并且由于缺乏标准化的调查工具，其差异可能很大。迫切需要更新一般人群的CP估计值。
为此，通过专家咨询进行设计和内容效度评估，开发了简短的五项慢性疼痛问卷；对用于一般人群调查中CP调查的测量方法进行文献分析；通过对受影响和未受影响个体的便利样本进行调查来评估可理解性；通过意大利双胞胎登记处进行的两次双波在线调查进行信度评估；通过2019年欧洲健康访谈调查（Ehis）的第三波进行标准效度和结构效度评估。
从公共卫生角度定义了关键维度，以描述CP的主要方面。文献分析表明，很少使用经过验证的问卷来处理重要的公共卫生CP方面。该测量方法的可理解性良好。重测分析表明该测量方法具有足够的信度：k值至少为“中等”，其中关于CP“发生”和“强度”的k值最高。2019年Ehis中检测到的CP与知名合并症（癌症、抑郁症）、特定特征（年龄、教育程度）以及CP及其强度与“身体疼痛的发生和强度”之间的相关性，分别证实了良好的结构效度和标准效度。还通过2019年Ehis中记录的“感知治疗效果”与“疼痛对日常生活活动的干扰”之间的相关性评估了结构效度。
所设计的问卷是一种简短的自我管理测量工具，特别适合在大规模一般人群调查中通过第一个筛选项目以及随后的四个项目来检测持续的疼痛状态及其相关强度。实际上，它旨在检测CP可能的潜在原因/触发因素、正在服用的药物/治疗方法及其频率，以及CP患者的自我感知效果。需要在不同的社会和文化背景下对该测量方法进行进一步验证。
