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Measurement properties of Pain Catastrophizing Scale in patients with knee osteoarthritis

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Abstract

Objectives

Pain catastrophizing impacts symptoms and outcomes for knee osteoarthritis (OA). We evaluated the internal consistency, content, construct and structure validity of the Pain Catastrophizing Scale (PCS) in patients with knee OA.

Methods

We evaluated content validity of PCS via cognitive interviews. We then recruited patients with knee OA enlisted for knee replacement (KR) surgery in a Singapore tertiary referral hospital for cross-sectional validation evaluation of PCS. Data was collected 2 weeks prior to KR. Analyses was guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework for internal consistency, construct validity and structure validity.

Results

Adequate content validity was confirmed from 10 patients in cognitive interviews. 675 (70.4% female, mean (standard deviation, SD) age = 65.52 (6.84) years) were included (91.7% total KR, 8.3% unicompartmental KR) in the cross-sectional study. The mean (SD) PCS score was 12.65 (10.55), with 0.14% and 8.63% ceiling and floor effects, respectively. PCS demonstrates high internal consistency (Cronbach’s alpha = 0.94). Construct validity was demonstrated by fulfilment of seven out of seven (100%) a priori hypotheses. PCS was strongly correlated with anxiety and depression, and moderately correlated with physical functioning and mental health domains of the short form 36 health survey (SF-36). Sensitivity analyses between Chinese and non-Chinese subgroups are generally consistent. From confirmatory factor analysis, the PCS model showed good fit for a second-order, three-factor structure (CFI = 0.965, TLI = 0.950, SRMR = 0.031).

Conclusions

This study supports internal consistency, construct validity and structural validity of PCS as a measure of pain catastrophizing in knee OA patients.

Key points

• The PCS is validated for measuring pain catastrophizing in knee OA patients, for evaluation of possible link to post-KR surgery satisfaction outcomes and other purposes.

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Authors and Affiliations

  1. Department of Rheumatology & Immunology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore

    Wei Jie Ong, Yu Heng Kwan, Zhui Ying Lim, Julian Thumboo & Ying Ying Leung

  2. Duke-NUS Medical School, 8 College Rd, Singapore, Singapore

    Wei Jie Ong, Yu Heng Kwan, Julian Thumboo & Ying Ying Leung

  3. Department of Orthopedics, Singapore General Hospital, Singapore, Singapore

    Seng Jin Yeo & William Yeo

  4. Department of Radiology, Sengkang General Hospital, Singapore, Singapore

    Steven B. Wong

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  1. Wei Jie Ong
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Ong, W.J., Kwan, Y.H., Lim, Z.Y. et al. Measurement properties of Pain Catastrophizing Scale in patients with knee osteoarthritis. Clin Rheumatol 40, 295–301 (2021). https://doi.org/10.1007/s10067-020-05163-8

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