Abstract
Purpose
The assessment of pain sensation and quality is a key component in understanding the experience of individuals with chronic pain. This study evaluated the factor structure of the patient-reported outcome measurement information system (PROMIS) pain quality item bank.
Methods
As part of the PROMIS project, we developed a pool of 37 pain quality items, based on a review of existing pain questionnaires and development of new items. A web-based survey was designed and completed by 845 members of the general population and 967 individuals with different types of chronic pain. Exploratory factor analysis (EFA) was conducted on a random split-half sample of the data to examine the factor structure of the 37 PROMIS pain quality items in the general population and in a chronic pain sample. A confirmatory factor analysis was conducted in the holdout sample.
Results
The EFA of the pain quality items resulted in comparable six-factor solutions for the general and chronic pain samples: (1) pulling/tugging pain; (2) tingling/numbness pain; (3) sharp/stabbing pain; (4) dull/aching pain; (5) pounding/pulsing pain; and (6) affective pain. The confirmatory factor analysis in the holdout sample supported this factor structure.
Conclusions
Further research is needed to evaluate the psychometric characteristics of the derived scales based on their factor scores.
Similar content being viewed by others
References
Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., et al. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113(1–2), 9–19.
Price, D. D., Harkins, S. W., & Baker, C. (1987). Sensory-affective relationships among different types of clinical and experimental pain. Pain, 28(3), 297–307.
Jensen, M. P. (2003). The validity and reliability of pain measures for use in clinical trials in adults. In Presented at the second meeting of the initiative on methods, measurement, and pain assessment in clinical trials (IMMPACT-II).
Price, D. D. (1999). Psychological mechanisms of pain and analgesia. Seattle: IASP Press.
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1(3), 277–299.
Melzack, R., & Katz, J. (2001). The McGill Pain Questionnaire: Appraisal and current status. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (2nd ed., pp. 659–692). New York: Guilford Press.
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30(2), 191–197.
Beattie, P. F., Dowda, M., & Feuerstein, M. (2004). Differentiating sensory and affective-sensory pain descriptions in patients undergoing magnetic resonance imaging for persistent low back pain. Pain, 110(1–2), 189–196. doi:10.1016/j.pain.2004.03.026.
Dworkin, R. H., Turk, D. C., Revicki, D. A., Harding, G., Coyne, K. S., Peirce-Sandner, S., et al. (2009). Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain, 144(1–2), 35–42.
Clark, W. C., Kuhl, J. P., Keohan, M. L., Knotkova, H., Winer, R. T., & Griswold, G. A. (2003). Factor analysis validates the cluster structure of the dendrogram underlying the multidimensional affect and pain survey (MAPS) and challenges the a priori classification of the descriptors in the McGill Pain Questionnaire (MPQ). Pain, 106(3), 357–363.
Jensen, M. P., Gammaitoni, A. R., Olaleye, D. O., Oleka, N., Nalamachu, S. R., & Galer, B. S. (2006). The pain quality assessment scale: Assessment of pain quality in carpal tunnel syndrome. Journal of Pain, 7(11), 823–832.
Byrne, M., Troy, A., Bradley, L. A., Marchisello, P. J., Geisinger, K. F., Van der Heide, L. H., et al. (1982). Cross-validation of the factor structure of the McGill Pain Questionnaire. Pain, 13(2), 193–201.
Crockett, D. J., Prkachin, K. M., Craig, K. D., & Greenstein, H. (1986). Social influences on factored dimensions of the McGill Pain Questionnaire. Journal of Psychosomatic Research, 30(4), 461–469.
Hasegawa, M., Hattori, S., Mishima, M., Matsumoto, I., Kimura, T., Baba, Y., et al. (2001). The McGill Pain Questionnaire, Japanese version, reconsidered: Confirming the theoretical structure. Pain Research and Management, 6(4), 173–180.
Lowe, N. K., Walker, S. N., & MacCallum, R. C. (1991). Confirming the theoretical structure of the McGill Pain Questionnaire in acute clinical pain. Pain, 46(1), 53–60.
Masedo, A. I., & Esteve, R. (2000). Some empirical evidence regarding the validity of the Spanish version of the McGill Pain Questionnaire (MPQ-SV). Pain, 85(3), 451–456.
Mystakidou, K., Parpa, E., Tsilika, E., Kalaidopoulou, O., Georgaki, S., Galanos, A., et al. (2002). Greek McGill Pain Questionnaire: Validation and utility in cancer patients. Journal of Pain and Symptom Management, 24(4), 379–387.
Reading, A. E. (1982). A comparison of the McGill Pain Questionnaire in chronic and acute pain. Pain, 13(2), 185–192.
Wright, K. D., Asmundson, G. J., & McCreary, D. R. (2001). Factorial validity of the short-form McGill pain questionnaire (SF-MPQ). European Journal of Pain, 5(3), 279–284. doi:10.1053/eujp.2001.0243.
Griswold, G. A., & Clark, W. C. (2005). Item analysis of cancer patient responses to the multidimensional affect and pain survey demonstrates high inter-item consistency and discriminability and determines the content of a short form. Journal of Pain, 6(2), 67–74.
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., et al. (2007). The patient-reported outcomes measurement information system (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Medical Care, 45(5 Suppl 1), S3–S11. doi:10.1097/01.mlr.0000258615.42478.55.
Reeve, B. B., Hays, R. D., Bjorner, J. B., Cook, K. F., Crane, P. K., Teresi, J. A., et al. (2007). Psychometric evaluation and calibration of health-related quality of life item banks: Plans for the patient-reported outcomes measurement information system (PROMIS). Medical Care, 45(5 Suppl 1), S22–S31. doi:10.1097/01.mlr.0000250483.85507.04.
Liu, H., Cella, D., Gershon, R., Shen, J., Morales, L. S., Riley, W., et al. (2010). Representativeness of the patient-reported outcomes measurement information system internet panel. Journal of Clinical Epidemiology, 63(11), 1169–1178. doi:10.1016/j.jclinepi.2009.11.021.
DeWalt, D. A., Rothrock, N., Yount, S., & Stone, A. A. (2007). Evaluation of item candidates: The PROMIS qualitative item review. Medical Care, 45(5 Suppl 1), S12–S21. doi:10.1097/01.mlr.0000254567.79743.e2.
Gorsuch, R. L. (1983). Factor analysis. Hillside, NJ: Lawrence Erlbaum.
Muthén, L. K., & Muthén, B. (2004). Mplus user’s guide (3rd ed.). Los Angeles, CA: Muthén & Muthén.
Victor, T. W., Jensen, M. P., Gammaitoni, A. R., Gould, E. M., White, R. E., & Galer, B. S. (2008). The dimensions of pain quality: Factor analysis of the Pain Quality Assessment Scale. Clinical Journal of Pain, 24(6), 550–555. doi:10.1097/AJP.0b013e31816b1058.
Revicki, D. A., Chen, W. H., Harnam, N., Cook, K. F., Amtmann, D., Callahan, L. F., et al. (2009). Development and psychometric analysis of the PROMIS pain behavior item bank. Pain, 146(1–2), 158–169. doi:10.1016/j.pain.2009.07.029.
Amtmann, D., Cook, K. F., Jensen, M. P., Chen, W. H., Choi, S., Revicki, D., et al. (2010). Development of a PROMIS item bank to measure pain interference. Pain, 150(1), 173–182. doi:10.1016/j.pain.2010.04.025.
Dworkin, R. H., Corbin, A. E., Young, J. P, Jr., Sharma, U., LaMoreaux, L., Bockbrader, H., et al. (2003). Pregabalin for the treatment of postherpetic neuralgia: A randomized, placebo-controlled trial. Neurology, 60(8), 1274–1283.
Rowbotham, M., Harden, N., Stacey, B., Bernstein, P., & Magnus-Miller, L. (1998). Gabapentin for the treatment of postherpetic neuralgia: A randomized controlled trial. Journal of the American Medical Association, 280(21), 1837–1842.
Acknowledgments
The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health (NIH) Roadmap initiative to develop a computerized system measuring patient-reported outcomes in respondents with a wide range of chronic diseases and demographic characteristics. NIH Science Officers on this project are Susan Czajkowski, PhD, Lawrence Fine, MD, DrPH, Laura Lee Johnson, Ph.D. Louis Quatrano, PhD, Bryce Reeve, PhD, William Riley, PhD, Susana Serrate-Sztein, MD, and James Witter, MD, PhD. This manuscript was reviewed by the PROMIS Publications Subcommittee prior to external peer review. See the web site at www.nihpromis.org for additional information on the PROMIS cooperative group.
Conflict of interest
PROMIS was funded by cooperative agreements to a Statistical Coordinating Center (NorthShore University Health System, PI: David Cella, PhD, U01AR52177) and six Primary Research Sites (Duke University, PI: Kevin Weinfurt, PhD, U01AR52186; University of North Carolina, PI: Darren DeWalt, MD, MPH, U01AR52181; University of Pittsburgh, PI: Paul A. Pilkonis, PhD, U01AR52155; Stanford University, PI: James Fries, MD, U01AR52158; Stony Brook University, PI: Arthur Stone, PhD, U01AR52170; and University of Washington, PI: Dagmar Amtmann, PhD, U01AR52171). The authors report no conflicts of interest related to this research and manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Revicki, D.A., Cook, K.F., Amtmann, D. et al. Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank. Qual Life Res 23, 245–255 (2014). https://doi.org/10.1007/s11136-013-0467-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-013-0467-9