Development and validation of the Penn Arthralgia Aging Scale among breast cancer survivors

Abstract

Purpose Breast cancer survivors on aromatase inhibitors often experience joint pain as a side effect of their treatment; qualitative investigations suggest that this arthralgia may cause women to feel they are aging faster than they should be. To facilitate further study of this experience, the Penn Arthralgia Aging Scale (PAAS) was developed. This report describes the development and validation of the PAAS in a racially diverse sample of breast cancer survivors suffering from joint pain. Patients and Methods Items of the scale were developed from a content analysis of interviews with patients. The scale was pilot-tested and modifications were made based on patient feedback. Subsequently, 556 breast cancer survivors who endorsed joint pain completed the eight-item PAAS. Factor structure (using exploratory factor analysis), internal consistency, and convergent, divergent, and incremental validity were examined. Results The resulting scale had a one-factor structure with strong internal consistency (Cronbach’s alpha=0.94), and demonstrated both convergent and divergent validity: The PAAS was significantly correlated with joint pain severity (r = .55, p < 0.01) and had a small and non-significant correlation with actual age (r = −0.07, p = 0.10). The PAAS was also found to predict incremental variance in anxiety, depression, and pain interference outcomes. Conclusion These findings suggest that the PAAS produced reliable and valid scores that capture perceptions of aging due to arthralgia among breast cancer survivors. With further research, the PAAS may advance our understanding of how perceptions of aging may affect breast cancer survivors’ emotional, behavioral and clinical outcomes.

Randomized placebo-controlled, double-blind clinical trial of nanoemulsion curcumin in women with aromatase inhibitor-induced arthropathy: an Alliance/NCORP pilot trial

“…Notably, we observed a non-significant trend for the BPI severity component of least pain in last 24 h when analyzing for ≥ 2 point improvement. A more nuanced assessment of pain with BPI Long Form (e.g., pain over a week) or Penn Arthralgia score[ 33 ] might refine our ability to evaluate AIIA and treatment efficacy in future studies.…”

Ageing perceptions and non-adherence to aromatase inhibitors among breast cancer survivors

“…As part of the baseline survey, all participants completed the Penn Arthralgia Aging Scale (PAAS), a measure that we previously developed and validated in a subset of the current sample. 20 The scale consists of eight items with a Likert-type scale ranging from 0 ( not at all ) to 4 ( completely ). Instructions ask participants to reflect on how their joint pain over the preceding week has impacted how they currently feel about their “bodies and states of mind.” Items are summed, with a maximum possible total score of 32.…”

“…17–19 In prior cross-sectional work we have found that among AI patients, arthralgia-associated aging perceptions explain variance in depression, anxiety, and the degree to which pain interferes with daily functioning, over and above pain severity. 20 In longitudinal analyses of non-cancer populations, negative aging perceptions have been associated with lower life satisfaction, worse objective physical functioning, and higher mortality risk, even after adjustments are made for health status. 21–26 Aging perceptions have also been linked to self-reported preventative health behaviors, such as diet and exercise.…”