Structural validity and reliability of the Spanish Central Sensitization Inventory in breast cancer survivors

Abstract

Introduction One of the most widely used instruments to identify symptoms that may be related to central sensitization is the Central Sensitization Inventory (CSI). Although this instrument has been translated and validated in Spanish patients with chronic musculoskeletal pain, no psychometric analysis has been carried out in breast cancer survivors. The aim of this study was to perform a psychometric analysis of the Spanish version of the Central Sensitization Inventory (CSI‐Sp) in Spanish breast cancer survivors. Materials and Methods A validation study was carried out in 183 breast cancer survivors. A psychometric analysis of internal consistency, factor structure, and test‐retest reliability of the CSI‐Sp was performed. Internal consistency was determined using Cronbach’s alpha. Test‐retest reliability was evaluated using the Intraclass Correlation Coefficient (ICC) Type 2.1. Exploratory factor analysis was used to determine the internal structure of the questionnaire. Results The internal consistency was high (α = 0.91). The test‐retest reliability was satisfactory with excellent values (ICC 2.1 = 0.95). The exploratory factor analysis yielded a one factor structure explaining the 33.88% of total variance. Conclusions The CSI‐Sp has demonstrated to be a psychometrically strong measure for assessing central sensitization symptoms in breast cancer survivors based on internal consistency, test‐retest reliability, and structural validity. Further studies that analyze other measurement properties in different Spanish clinical populations are needed.

Assessment of Central Sensitization in Breast Cancer Survivors: Convergent Validity and Use of the Central Sensitization Inventory (CSI) and Its Short-Form as a Clustering Tool

“…The internal consistency of the CSI was excellent (α = 0.92), which is in line with previous reports that found values ranging from 0.87 to 0.91 [ 20 , 22 ]. A recent study evaluating the CSI in BCS found that an exploratory factor analysis yielded a one factor structure, which indicates that the CSI items measure the same construct [ 22 ]. Furthermore, a high internal consistency usually indicates that there are too much identical or comparable items, which supports the development of the CSI-9.…”

“…Moderate associations were found between CSI outcome and the EORTC physical (r s = −0.56) and role (r s = −0.60). Several authors have reported moderate correlations between the CSI and physical functioning measures [ 22 , 38 , 41 ]. The CSI yielded moderate correlations with the EORTC fatigue (r s = 0.68) and insomnia (r s = 0.59), which are symptoms commonly associated with CS [ 17 , 35 ].…”

“…Part B asks if the patient has been previously diagnosed with seven CSS and three CSS-associated diagnoses, but it was not considered in our study. It was shown that a bifactor model containing one general factor representing “CS-related symptoms” and four orthogonal factors of “physical symptoms,” “emotional distress,” “headache/jaw symptoms” and “urological symptoms” fits the CSI structure the best [ 21 , 22 ]. The CSI has been found to be psychometrically sound in all published studies to date [ 13 , 20 , 26 ].…”

“…Recently, Cuestas Vargas et al developed a CSI cluster calculator (CSI-CC) that proposes to classify patients in three groups of CS-related symptom severity based on their answers [ 19 ]. The psychometric properties of the CSI in patients having nonspecific, noncancer pain are well-established, but studies examining the reliability and validity of either the CSI or the CSI-9 in cancer patients or cancer survivors are scarce [ 20 , 21 , 22 ]. This is an important knowledge gap, especially given the importance of CS as a key underlying mechanism for pain in BCS, as well as the potential of the CSI to serve pain phenotyping in cancer survivors [ 10 , 11 , 23 ].…”

Factors associated with upper limb function in breast cancer survivors

“…Central sensitization symptoms: The Spanish version of Central Sensitisation Inventory (CSI‐Sp) was used. CSI shows positive results in internal consistency ( α = .872) and test‐retest reliability ( r = .91), 28 as well as good psychometric properties among breast cancer survivors 29 . It has two sections: Section A has 25 items broken down into categories (never, rarely, sometimes, often, always), whereas Section B deals with medical diagnosis.…”