Swartzman Leora C, Gwadry Fuad G, Shapiro Allan P, Teasell Robert W
Department of Psychology, University of Western Ontario, London, Ont. N6A 5C2 Canada Department of Psychological Services, University Hospital, London, Ont. N6A 5A5 Canada Department of Physical Medicine and Rehabilitation, University of Western Ontario, University Hospital, London, Ont. N6A 5A5 Canada.
Pain. 1994 Jun;57(3):311-316. doi: 10.1016/0304-3959(94)90006-X.
The Coping Strategies Questionnaire (CSQ) (Rosenstiel and Keefe 1983) is the most widely used measure of pain coping strategies. To date, with one exception (Tuttle et al. 1991), studies examining the factor structure of the CSQ have used the composite scores of its 8 a-priori theoretically derived scales rather than the 48 individual items. An examination of the match between the 8 theoretically derived scales and scales empirically extracted from an item analysis is lacking. Accordingly, the CSQ was administered to 126 chronic pain (whiplash) patients. Factor analyses of the individual items revealed an 8-factor structure to be uninterpretable. Of the 2-9-factor solutions tested, the 5-factor structure was the most interpretable: Factor 1, Distraction; Factor 2, Ignoring Pain Sensations; Factor 3, Reinterpreting Pain Sensations; Factor 4, Catastrophizing; Factor 5, Praying and Hoping. Eighteen Ph.D. or M.D. level clinicians classified items into their corresponding category with a high degree of accuracy (on average, 90.2%), attesting to the face and construct validity of the subscales. Four subscales, Catastrophizing, Reinterpreting Pain Sensations, Praying and Hoping and (to a lesser degree) Ignoring Pain Sensations, correspond with parallel subscales proposed by Rosensteil and Keefe (1983). The fifth subscale, Distraction, is comprised of items from their Diverting Attention and Increasing Activity Level subscales, suggesting that cognitive and behavioural distraction comprise 1 rather than 2 coping strategies. That CSQ items on the original Coping Self-Statements and the Increasing Pain Behaviour subscales failed to load consistently on any factor suggests that they do not reliably measure distinct coping strategies.(ABSTRACT TRUNCATED AT 250 WORDS)
应对策略问卷（CSQ）（罗森斯蒂尔和基夫，1983年）是测量疼痛应对策略使用最为广泛的工具。迄今为止，除一项研究（塔特尔等人，1991年）外，考察CSQ因子结构的研究均使用其8个先验理论衍生量表的综合得分，而非48个单个项目。目前尚缺乏对8个理论衍生量表与从项目分析中实证提取的量表之间匹配度的考察。因此，对126名慢性疼痛（挥鞭样损伤）患者施测了CSQ。对单个项目的因子分析显示，8因子结构无法解释。在测试的2 - 9因子解决方案中，5因子结构最具可解释性：因子1为分散注意力；因子2为忽视疼痛感觉；因子3为重新诠释疼痛感觉；因子4为灾难化思维；因子5为祈祷与希望。18名博士或医学博士水平的临床医生将项目准确归类到相应类别（平均准确率为90.2%），证明了分量表的表面效度和结构效度。四个分量表，即灾难化思维、重新诠释疼痛感觉、祈祷与希望以及（程度稍轻的）忽视疼痛感觉，与罗森斯蒂尔和基夫（1983年）提出的平行分量表相对应。第五个分量表，即分散注意力，由他们的转移注意力和提高活动水平分量表中的项目组成，这表明认知和行为分散注意力构成1种而非2种应对策略。原始应对自我陈述和增加疼痛行为分量表上的CSQ项目未能始终如一地加载到任何因子上，这表明它们不能可靠地测量不同的应对策略。（摘要截短至250字）
