Quality of Life Research

, Volume 19, Issue 6, pp 847–852

Cross-cultural adaptation and validation of a Brazilian Portuguese version of the chronic pain grade

  • Eduardo S. B. Bracher
  • Ricardo Pietrobon
  • José Eluf-Neto
Brief Communication

Abstract

Purpose

To verify the reliability and validity of a Brazilian Portuguese version of the chronic pain grade (CPG-Br).

Methods

Cultural adaptation was made in accordance with established guidelines, with modifications aiming at improving this process. Adaptations were made based on interviews with 45 chronic pain patients from São Paulo city. Validation was studied by concurrent application of the short-form-36 health survey (SF-36) and other questionnaires to 283 participants with chronic pain from the general population. Temporal stability was verified by a second application to 131 individuals.

Results

Factor analysis resulted in a two-factor solution with factors named characteristic pain intensity and activity limitation due to pain. Alpha coefficients of 0.78 and 0.70 and intraclass correlation coefficients of 0.76 and 0.72 for each factor indicated good internal consistency and temporal stability. Significant correlations between CPG-Br and SF-36, Roland-Morris disability questionnaire and neck disability index scores were noted. A consistent linear trend was also observed between pain grades and SF-36 scores. Frequency of use of pain medications and of pain-related medical visits increased with pain grade.

Conclusion

This Brazilian Portuguese version of the chronic pain grade, tested on a sample of the Brazilian population, demonstrated good reliability and validity.

Keywords

Pain Pain measurement Quality of life Validation studies Cross-cultural comparison Scales 

References

  1. 1.
    Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10, 287–333.CrossRefPubMedGoogle Scholar
  2. 2.
    Elliott, A. M., Smith, B. H., Penny, K. I., Smith, W. C., & Chambers, W. A. (1999). The epidemiology of chronic pain in the community. Lancet, 354, 1248–1252.CrossRefPubMedGoogle Scholar
  3. 3.
    Verhaak, P. F., Kerssens, J. J., Dekker, J., Sorbi, M. J., & Bensing, J. M. (1998). Prevalence of chronic benign pain disorder among adults: A review of the literature. Pain, 77, 231–239.CrossRefPubMedGoogle Scholar
  4. 4.
    Gureje, O., Von Korff, M., Simon, G. E., & Gater, R. (1998). Persistent pain and well-being: A World Health Organization Study in Primary Care. Journal of the American Medical Association, 280, 147–151.CrossRefPubMedGoogle Scholar
  5. 5.
    Moore, R., & Brødsgaard, I. (1999). Cross-cultural investigations of pain. In I. K. Crombie, P. R. Croft, S. J. Linton, L. LeResche, & M. Von Korff (Eds.), Epidemiology of pain (pp. 53–79). Seattle: International Association for the Study of Pain.Google Scholar
  6. 6.
    Smith, B. H., Macfarlane, G. J., & Torrance, N. (2007). Epidemiology of chronic pain, from the laboratory to the bus stop: Time to add understanding of biological mechanisms to the study of risk factors in population-based research? Pain, 127, 5–10.CrossRefPubMedGoogle Scholar
  7. 7.
    Cassidy, J. D., Côté, P., Carroll, L. J., & Kristman, V. (2005). Incidence and course of low back pain episodes in the general population. Spine, 30, 2817–2823.CrossRefPubMedGoogle Scholar
  8. 8.
    Elliott, A. M., Smith, B. H., Hannaford, P. C., Smith, W. C., & Chambers, W. A. (2002). The course of chronic pain in the community: Results of a 4-year follow-up study. Pain, 99, 299–307.CrossRefPubMedGoogle Scholar
  9. 9.
    UK BEAM Trial Team. (2004). United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: Cost effectiveness of physical treatments for back pain in primary care. British Medical Journal, 329, 1381–1385.CrossRefGoogle Scholar
  10. 10.
    Von Korff, M., Balderson, B. H., Saunders, K., Miglioretti, D. L., Lin, E. H., Berry, S., et al. (2005). A trial of an activating intervention for chronic back pain in primary care and physical therapy settings. Pain, 113, 323–330.CrossRefGoogle Scholar
  11. 11.
    Carroll, L. J., Cassidy, J. D., & Côté, P. (2004). Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain, 107, 134–139.CrossRefPubMedGoogle Scholar
  12. 12.
    Mercado, A. C., Carroll, L. J., Cassidy, J. D., & Côté, P. (2005). Passive coping is a risk factor for disabling neck or low back pain. Pain, 117, 51–57.CrossRefPubMedGoogle Scholar
  13. 13.
    Kreling, M. C., Cruz, D. A., & Pimenta, C. A. (2006). Prevalence of chronic pain in adult workers. Revista Brasileira de Enfermagem, 59, 509–513.CrossRefPubMedGoogle Scholar
  14. 14.
    Sá, K., Baptista, A. F., Matos, M. A., & Lessa, I. (2009). Prevalence of chronic pain and associated factors in the population of Salvador, Bahia. Revista de Saude Publica, 43, 622–630.PubMedGoogle Scholar
  15. 15.
    Von Korff, M., Ormel, J., Keefe, F. J., & Dworkin, S. F. (1992). Grading the severity of chronic pain. Pain, 50, 133–149.CrossRefGoogle Scholar
  16. 16.
    Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25, 3186–3191.CrossRefPubMedGoogle Scholar
  17. 17.
    Guillemin, F., Bombardier, D., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46, 1417–1432.CrossRefPubMedGoogle Scholar
  18. 18.
    Ciconelli, R. M., Ferraz, M. B., Santos, W., Meinão, I., & Quaresma, M. R. (1999). Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Revista Brasileira de Reumatologia, 39, 143–150.Google Scholar
  19. 19.
    Nusbaum, L., Natour, J., Ferraz, M. B., & Goldenberg, J. (2001). Translation, adaptation and validation of the Roland-Morris questionnaire—Brazil Roland-Morris. Brazilian Journal of Medical and Biological Research, 34, 203–210.CrossRefPubMedGoogle Scholar
  20. 20.
    Cook, C., Richardson, J. K., Braga, L., Menezes, A., Soler, X., Kume, P., et al. (2006). Cross-cultural adaptation and validation of the Brazilian Portuguese version of the neck disability index and neck pain and disability scale. Spine, 31, 1621–1627.CrossRefPubMedGoogle Scholar
  21. 21.
    Pett, M. A., Lackey, N. R., & Sullivan, J. J. (2003). Rotating the factors. In M. A. Pett, N. R. Lackey, & J. J. Sullivan (Eds.), Making sense of factor analysis (pp. 131–166). Thousand Oaks: Sage.Google Scholar
  22. 22.
    Salaffi, F., Stancati, A., & Grassi, W. (2006). Reliability and validity of the Italian version of the Chronic Pain Grade questionnaire in patients with musculoskeletal disorders. Clinical Rheumatology, 25, 619–631.CrossRefPubMedGoogle Scholar
  23. 23.
    Smith, B. H., Penny, K. I., Purves, A. M., Munro, C., Wilson, B., Grimshaw, J., et al. (1997). The Chronic Pain Grade questionnaire: Validation and reliability in postal research. Pain, 71, 141–147.CrossRefPubMedGoogle Scholar
  24. 24.
    Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.CrossRefPubMedGoogle Scholar
  25. 25.
    Cicchetti, D. V., & Sparrow, S. A. (1981). Developing criteria for establishing interrater reliability of specific items: Applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86, 127–137.PubMedGoogle Scholar
  26. 26.
    Ware, J. E., Kosinski, M., Gandek, B., Aaronson, N. K., Apolone, G., Bech, P., et al. (1998). The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 1159–1165.CrossRefPubMedGoogle Scholar
  27. 27.
    Becker, N., Thomsen, A. B., Olsen, A. K., Sjrogen, P. B., & Eriksen, J. (1997). Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center. Pain, 73, 393–400.CrossRefPubMedGoogle Scholar
  28. 28.
    Elliott, A. M., Smith, B. H., Smith, W. C., & Chambers, W. A. (2000). Changes in chronic pain severity over time: The Chronic Pain Grade as a valid measure. Pain, 88, 303–308.CrossRefPubMedGoogle Scholar
  29. 29.
    Penny, K. I., Purves, A. M., Smith, B. H., Chambers, W. A., & Smith, W. C. (1999). Relationship between the chronic pain grade and measures of physical, social and psychological well-being. Pain, 79, 275–279.CrossRefPubMedGoogle Scholar
  30. 30.
    Tüzün, E. H. (2007). Quality of life in chronic musculoskeletal pain. Best Practice & Research Clinical Rheumatology, 21, 567–579.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Eduardo S. B. Bracher
    • 1
  • Ricardo Pietrobon
    • 2
  • José Eluf-Neto
    • 1
  1. 1.Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
  2. 2.Department of SurgeryDuke UniversityDurhamUSA

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