Measuring Pain Catastrophizing and Pain-Related Self-Efficacy: Expert Panels, Focus Groups, and Cognitive Interviews
Pain-related self-efficacy and pain catastrophizing are important psychosocial determinants of pain and can be therapeutic targets for chronic pain management. Advances in psychometric science have made shorter or dynamically administered instruments possible. The aim of this study was to generate and test candidate items for two new patient-reported outcome measures of pain-related self-efficacy and pain catastrophizing.
An expert panel of pain clinicians and researchers was convened to establish construct definitions of pain-related self-efficacy and pain catastrophizing and guide item development. Two patient advisors provided guidance throughout the project. Nineteen people with chronic pain participated in focus groups about their perspectives and experiences related to pain-related self-efficacy and pain catastrophizing. Twenty-two people with chronic pain participated in cognitive interviews to test proposed candidate items.
Saturation was reached after three focus groups with no new subdomains identified by participants in the third focus group. Following cognitive interviews, five of the 48 initial pain-related self-efficacy candidate items were dropped and seven required substantial revision resulting in 43 pain-related self-efficacy candidate items. After two rounds of cognitive interviews, ten items were eliminated and ten substantially revised, resulting in a set of 30 from the initial 43 pain catastrophizing candidate items.
This article summarizes results of the qualitative phase of the development of new measures of pain-related self-efficacy and pain catastrophizing. Candidate items will be field tested with a large sample of people with chronic pain and the data will be used to calibrate items to an item response theory model. Resulting item banks and short forms will be made publicly available to researchers and clinicians.
We thank our two patient advisors who provided exceptional insight concerning the patient perspective on chronic pain. Mary R. Scott, who has since passed away and was a member of the UW Patient Voices Network that includes patients interested in research, and Penney Cowan, who is a founder of the American Chronic Pain Association. We also thank the members of the expert panel for providing valuable contribution to the new instruments. These included Frank Keefe, PhD, Michael Nicholas, PhD, Beverly Thorn, PhD, Judith Turner, PhD, and Michael Sullivan, PhD.
Dagmar Amtmann, Kendra Liljenquist, Alyssa Bamer, Fraser Bocell, Mark Jensen, Rozanne Wilson, and Dennis Turk contributed to all aspects of the article including conception and design, acquisition of data, and analysis and interpretation of data.
Compliance with Ethical Standards
This study was funded by the Patient-Centered Outcomes Research Institute (ME-1403-12550) and the National Institute on Disability, Independent Living and Rehabilitation Research (H133P120002).
Conflict of interest
Dagmar Amtmann, Kendra Liljenquist, Alyssa Bamer, Fraser Bocell, Mark Jensen, Rozanne Wilson, and Dennis Turk have no conflicts of interest directly relevant to the content of this article.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.
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