Clinimetric properties of the Nepali version of the Pain Catastrophizing Scale in individuals with chronic pain

Abstract

BackgroundPain catastrophizing is an exaggerated negative cognitive response related to pain. It is commonly assessed using the Pain Catastrophizing Scale (PCS). Translation and validation of the scale in a new language would facilitate cross-cultural comparisons of the role that pain catastrophizing plays in patient function.PurposeThe aim of this study was to translate and culturally adapt the PCS into Nepali (Nepali version of PCS [PCS-NP]) and evaluate its clinimetric properties.MethodsWe translated, cross-culturally adapted, and performed an exploratory factor analysis (EFA) of the PCS-NP in a sample of adults with chronic pain (N=143). We then confirmed the resulting factor model in a separate sample (N=272) and compared this model with 1-, 2-, and 3-factor models previously identified using confirmatory factor analyses (CFAs). We also computed internal consistencies, test–retest reliabilities, standard error of measurement (SEM), minimal detectable change (MDC), and limits of agreement with 95% confidence interval (LOA95%) of the PCS-NP scales. Concurrent validity with measures of depression, anxiety, and pain intensity was assessed by computing Pearson’s correlation coefficients.ResultsThe PCS-NP was comprehensible and culturally acceptable. We extracted a two-factor solution using EFA and confirmed this model using CFAs in the second sample. Adequate fit was also found for a one-factor model and different two- and three-factor models based on prior studies. The PCS-NP scores evidenced excellent reliability and temporal stability, and demonstrated validity via moderate-to-strong associations with measures of depression, anxiety, and pain intensity. The SEM and MDC for the PCS-NP total score were 2.52 and 7.86, respectively (range of PCS scores 0–52). LOA95% was between −15.17 and +16.02 for the total PCS-NP scores.ConclusionThe PCS-NP is a valid and reliable instrument to assess pain catastrophizing in Nepalese individuals with chronic pain.

Development of the Hausa Version of the Pain Catastrophizing Scale: Translation, Cross-Cultural Adaptation and Psychometric Evaluation in Mixed Urban and Rural Patients with Chronic Low Back Pain

“…The test-retest reliability of the Hausa-PCS total score was highly adequate (ICC = 0.90) suggesting excellent reproducibility. Our value is higher than the original English version (ICC = 0.73) [23] and the range of 0.76-0.85 obtained by several language versions [33, 37, 39-43, 45, 47], consistent with the 0.90 obtained for the Afrikaans [35], Japanese [84], Nepali [77] and Xhosa [35] versions but slightly lower than the range of 0.92-0.97 obtained by other language versions [36,38,44,76]. However, for the Hausa-PCS subscales, the ICC was only adequate for the helplessness subscale (ICC = 0.89).…”

“…This nding is similar to the reports of many validations conducted in different samples of individuals with chronic pain [39,79,80,82]. On the contrary, other validations found the two-factor structure of the PCS to exhibit adequate model t [48,77]. In another vein, the Huijer et al [34] found the one-factor, two-factor (based on the authors' EFA), and Sullivan's original three-factor structures all exhibited adequate t to the Arabic population.…”

“…The PCS has been widely reported to poses a three-factor structure consisting of the rumination, magni cation and helplessness subscales following EFA [24, 37, 39-42, 44, 45, 47, 65, 76] even though minor differences exist regarding how the PCS items loaded onto factors. A two-factor structure has been also reported in the literature [24,48,77,[79][80][81][82]. In the present study, the result of the EFA with Promax rotation suggested the same three-factor structure as found in the original English version [23].…”

“…As for the MDC (9.62), a change of 9.7 can be considered as a true change in the total score above measurement error. Additionally, the result of the Bland-Altman plot for the Hausa-PCS total score showed minimal bias as the mean difference (0.87) calculated was close to zero, with LOA 95% of − 8.10 to 9.75 which lies within the range of − 15.1 to 16.0 reported in the literature [43,44,76,77] One strength of this study is that the translation and cross-cultural adaptation was conducted as per the recommendation of standard guidelines outlined by Beaton et al [64]. Additionally, the psychometric evaluation was conducted and reported in line with the COSMIN guidelines [73] even though we did not use the global rating of change scale to con rm the respondents' stability for reliability assessments.…”

“…The smaller the SEM the better the reliability (precision) of the measure whereas the smaller the MDC the more sensitive is the measure [87]. In the present study, the SEM (3.47) and MDC (9.62) values calculated for the Hausa-PCS total score were comparable to the values for the Afrikaans (SEM = 3.30; MDC = 9.00) [35] and Xhosa (SEM = 3.30; MDC = 9.30) [35]; lower than the values calculated for the Korean (SEM = 3.72; MDC = 10.3) [41], German (SEM = 4.6; MDC = 12.8) [39] or Norwegian (SEM = 4.60; MDC = 12.8) [43] versions; but higher than the values for the Hindi (SEM = 1.90; MDC = 5.26) [76] and Nepali (SEM = 2.52; MDC = 6.98) [77] versions. Compared to the SEM and MDC values of the Hausa-PCS total score, the three subscales of the questionnaire demonstrated lower values consistent with the reports of prior studies [35,43,76].…”