A measure for quality of life assessment in chronic pain: preliminary properties of the WHOQOL-pain
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Chronic pain has a considerable impact on patient-reported outcomes such as quality of life (QoL). To assess QoL in people with chronic pain, a pain and discomfort module (PDM) was developed for use with the WHOQOL-100 and its psychometric properties assessed. Sixteen items covered four facets on pain relief; anger and frustration; vulnerability, fear and worry; and uncertainty. Chronic low back pain patients (n = 133) (age 56; pain duration 85 months; 65% female) completed the WHOQOL-100 and PDM, McGill Pain Questionnaire, and SF-12. The PDM showed good internal consistency reliability (α = .88) (alphas .66–.81). Except for anger, all facets associated most strongly with their ‘parent’ domain. Pain and poorer QoL were strongly associated, supporting construct validity. The SF-12 physical health component associated strongly with pain relief, and the mental health score with other facets, indicating good concurrent validity. Discriminant validity tests showed that PDM scores distinguished between ill and well patients, and between those reporting different health statuses. The PDM has fair to good psychometric properties indicating its value as a patient-reported outcome measure for clinical trials.
KeywordsChronic low back pain Quality of life WHOQOL-100 WHOQOL-pain Reliability Validity
The Economic and Social Research Council (UK) funded this research. The authors thank Sister Liz Phelps, Dr Monica Baird, Dr Steven Hill, Dr Andrew Souter, Dr Ellis, Dr Arora, Staff Nurse Sarah Morgan, Beth Mathias and all those in pain who participated in this study. The foundation work of the WHOQOL Group is acknowledged.
- Ackerman, I. N., Graves, S. E., Bennell, K. L., & Osborne, R. H. (2006). Evaluating quality of life in hip and knee replacement: Psychometric properties of the World Health Organization Quality of Life short version instrument. Arthritis and Rheumatism, 55(4), 583–590. doi: 10.1002/art.22107.PubMedCrossRefGoogle Scholar
- Comrey, A. L., & Lee, H. B. (1992). A first course in factor analysis (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
- Jenkinson, C., & Layte, R. (1997). Development and testing of the UK SF-12 (short form health survey). Journal of Health Services Research & Policy, 2, 14–18.Google Scholar
- Juniper, E. F., Guyatt, G. H., & Jaeschke, R. (1996). How to develop and validate a new health-related quality of life instrument. In B. Spilker (Ed.), Quality of life and pharmacoeconomics in clinical trials (2nd ed., pp. 49–56). Philadelphia: Lippincott-Raven.Google Scholar
- Melzack, R., & Katz, J. (1994). Pain measurement in persons with pain. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (3rd ed.). London: Churchill Livingstone.Google Scholar
- Melzack, R., & Katz, J. (1999). Pain measurement in persons with pain. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (4th ed.). London: Churchill Livingstone.Google Scholar
- Skevington, S. M., Sartorius, N., Amir, M., & WHOQOL Group. (2004). Developing methods for assessing quality of life in different cultural settings: The history of the WHOQOL instruments. Social Psychiatry and Psychiatric Epidemiology, 39(1), 1–8. doi: 10.1007/s00127-004-0700-5.PubMedCrossRefGoogle Scholar
- Streiner, D. L., & Norman, G. R. (1995). Health Measurement Scales: A practical guide to their development and use (2nd ed.). Oxford: Oxford University Press.Google Scholar
- Sturgis, P., Thomas, R., Purdon, S., Bridgwood, A., & Dodd, T. (2001). Comparative Review of Key Health Status Measures of the General Population. Department of Health, UK. Accessed June 9, 2008 http://staff.soc.surrey.ac.uk/psturgis/papers/healthreport.pdf.
- Taylor, W. J., Myers, J., Simpson, R. T., McPherson, K. M., & Weatherall, M. (2004). Quality of life of people with rheumatoid arthritis as measured by the World Health Organization Quality of Life Instrument, short form (WHOQOL-BREF): Score distributions and psychometric properties. Arthritis and Rheumatism, 51(3), 350–357. doi: 10.1002/art.20398.PubMedCrossRefGoogle Scholar
- Theiler, R., Bischoff, H. A., Good, M., & Uebelhart, D. (2002). Rofecoxib improves quality of life in patients with hip or knee osteoarthritis. Swiss Medical Weekly, 132, 573.Google Scholar
- Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 Physical and Mental Health Summary Scales: A user manual. Boston, Massachusetts: The Health Institute, New England Medical Center.Google Scholar