Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain

Abstract

BackgroundPain catastrophizing has been found to be an important predictor of disability and days lost from work in patients with low back pain. The most commonly used outcome measure to identify pain catastrophizing is the Pain Catastrophizing Scale (PCS). To enable the use of the PCS in clinical settings and research in Norwegian speaking patients, the PCS had to be translated. The purpose of this study was therefore to translate and cross-culturally adapt the PCS into Norwegian and to test internal consistency, construct validity and reproducibility of the PCS.MethodsThe PCS was translated before it was tested for psychometric properties. Patients with subacute or chronic non-specific low back pain aged 18 years or more were recruited from primary and secondary care. Validity of the PCS was assessed by evaluating data quality (missing, floor and ceiling effects), principal components analysis, internal consistency (Cronbach’s alpha), and construct validity (Spearman’s rho). Reproducibility analyses included standard error of measurement, minimum detectable change, limits of agreement, and intraclass correlation coefficients.ResultsA total of 38 men and 52 women (n = 90), with a mean (SD) age of 47.6 (11.7) years, were included for baseline testing. A subgroup of 61 patients was included for test-retest assessments. The Norwegian PCS was easy-to-comprehend. The principal components analysis supported a three-factor structure, internal consistency was satisfactory for the PCS total score (α 0.90) and the subscales rumination (α 0.83) and helplessness (α 0.86), but not for the subscale magnification (α 0.53). In total, 86% of the correlation analyses were in accordance with predefined hypothesis. The reliability analyses showed intraclass correlation coefficients of 0.74 − 0.87 for the PCS total score and subscales. The PCS total score (range 0–52 points) showed a standard error of measurement of 4.6 points and a 95% minimum detectable change estimate of 12.8 points.ConclusionsThe Norwegian PCS total score showed acceptable psychometric properties in terms of comprehensibility, consistency, construct validity, and reproducibility when applied to patients with subacute or chronic LBP from different clinical settings. Our study support the use of the PCS total score for clinical or research purposes identifying or evaluating pain catastrophizing.

Psychometric properties of the Brazilian version of the Pain Catastrophizing Scale for acute low back pain

“…The average level of pain catastrophizing was 29.2 (± 13.1) points, corroborating the results of other versions 26,29 and going against those of Fernandes et al 25 . In this study, the average level was 14 points, but the population was of young adults with subacute lower back pain, which may have led to different results.…”

“…The indexes of separation of items and of individuals showed that the scale is able to divide the people into approximately three levels of catastrophizing (low, medium and high), as described by Fernandes et al 25 and five levels of expression of catastrophizing.…”

“…The adjusted version of the PCS was validated for elderly Brazilians with acute lower back pain and presented psychometric characteristics equivalent to the other versions 8,25,26 .…”

Factors associated with the Pain Catastrophizing Scale and validation in a sample of the Turkish population

“…The literature contends that patients who tend to catastrophize perceive pain as stronger than it actually is (1,2). Patients who catastrophize exaggerate pain, ruminate about painful sensations, and show an inability to control pain.…”

Factorial Validity of the English-Language Version of the Pain Catastrophizing Scale–Child Version

“…44 The Pain Catastrophizing Scale (PCS) was originally developed in English to assess pain catastrophizing in adults. 35 It has been validated in several languages 12,14,23,25,26,47 and adapted for use in several age groups, 9,38 by adults to assess catastrophizing about their significant other's pain, 4 and by parents to assess catastrophizing about their child's pain. 15 The PCS was adapted for use with Flemish-speaking children aged 9 to 16 years (Pain Catastrophizing Scale-Child [PCS-C] 9 ).…”