Navarrete Jaime, Rodríguez-Freire Carla, Sanabria-Mazo Juan P, Martínez-Rubio David, McCracken Lance M, Gallego Ana, Sundstrom Felicia T A, Serrat Mayte, Alonso Jordi, Feliu-Soler Albert, Nieto Rubén, Luciano Juan V
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Eur J Pain. 2025 Jan;29(1):e4704. doi: 10.1002/ejp.4704. Epub 2024 Jul 19.
Acceptance and Commitment Therapy (ACT) has been found to be beneficial for individuals dealing with chronic pain. The theoretical mechanisms of change proposed by ACT are based on the Hexaflex model. To comprehensively reflect this model, the Multidimensional Psychological Flexibility Inventory (MPFI) and Psy-Flex have been developed. The study aimed to adapt the MPFI-24 and the Psy-Flex for Spanish-speaking populations with chronic pain and to examine their dimensionality, internal consistency, convergent validity and incremental validity.
This cross-sectional study involved 309 Spanish-speaking adults with chronic pain who completed an online survey. The majority of the participants were women (88.3%). The ages ranged from 18 to 79 years.
Factor analysis showed that the Spanish version of the MPFI-24 has 12 factors, consisting of six flexibility and six inflexibility factors, similar to the original version, but lacking second-order general factors. The Psy-Flex demonstrated a single-factor structure, maintaining the general factor of psychological flexibility seen in the original version. The MPFI-24 showed good internal consistency and adequate convergent validity, with the exception of the Acceptance and Experiential Avoidance subscales. The Psy-Flex showed good internal consistency and convergent validity. Notably, both the MPFI-24 and Psy-Flex scores significantly explained additional variance in psychological distress beyond other ACT-related measures of Hexaflex processes; however, only the Psy-Flex explained pain interference.
The Spanish adaptations of the MPFI-24 and Psy-Flex are valid and reliable instruments for assessing the Hexaflex model processes in Spanish-speaking adults with chronic pain.
Practitioners and researchers in chronic pain will find the Spanish versions of the MPFI-24 and the Psy-Flex here, along with recommendations for their use and scoring based on a robust psychometric rationale. It should be noted that these measures surpass the Chronic Pain Acceptance Questionnaire (CPAQ) and the Psychological Inflexibility in Pain Scale (PIPS), which are considered gold standards in chronic pain assessment.
已发现接纳与承诺疗法（ACT）对慢性疼痛患者有益。ACT提出的理论改变机制基于Hexaflex模型。为全面反映该模型，已开发出多维心理灵活性量表（MPFI）和心理灵活性量表（Psy-Flex）。本研究旨在使MPFI - 24和Psy-Flex适用于讲西班牙语的慢性疼痛人群，并检验其维度、内部一致性、收敛效度和增量效度。
这项横断面研究纳入了309名讲西班牙语的慢性疼痛成年人，他们完成了一项在线调查。大多数参与者为女性（88.3%）。年龄范围为18至79岁。
因素分析表明，西班牙语版的MPFI - 24有12个因素，包括六个灵活性因素和六个不灵活性因素，与原版相似，但缺乏二阶一般因素。Psy-Flex呈现单因素结构，保留了原版中所见的心理灵活性一般因素。MPFI - 24显示出良好的内部一致性和充分的收敛效度，但接纳与经验性回避分量表除外。Psy-Flex显示出良好的内部一致性和收敛效度。值得注意的是，MPFI - 24和Psy-Flex得分均显著解释了心理困扰中超出其他与ACT相关的Hexaflex过程测量指标的额外方差；然而，只有Psy-Flex解释了疼痛干扰。
MPFI - 24和Psy-Flex的西班牙语改编版是评估讲西班牙语的慢性疼痛成年人Hexaflex模型过程的有效且可靠工具。
慢性疼痛领域的从业者和研究人员将在此处找到MPFI - 24和Psy-Flex的西班牙语版本，以及基于强大心理测量原理的使用和计分建议。应注意的是，这些测量工具超越了慢性疼痛接纳问卷（CPAQ）和疼痛心理不灵活性量表（PIPS），它们被视为慢性疼痛评估的金标准。
