Translation and validation of Simplified Chinese version of the Pain Catastrophizing Scale in chronic pain patients: Education may matter

Abstract

ObjectivePain catastrophizing is linked to many aspects of pain perception and defines a unique dimension in predicting pain intensity and physical disability. Pain Catastrophizing Scale (PCS) is an effective, validated,self-report measure, commonly used in clinical trials. Here, we present a Simplified Chinese PCS (SC-PCS) version developed in Chinese patients suffering from chronic pain.MethodsThe SC-PCS was generated in five steps and tested on an initial patient cohort (N = 30). A convenience sample (N = 200) of in-hospital patients with non-malignant pain lasting for more than 12 weeks were recruited for the study, of which 81 completed 5 additional pain questionnaires. A subset (N = 24) of the patients completed an additional SC-PCS, 10 days after the initial query to assess test–retest validation.ResultsIntra-class correlations coefficient indicated high reproducibility and temporal consistency, (0.97), for the total score. Cronbach’s alpha determined high internal consistency across the SC-PCS total score and its three subscales (0.87, 0.85, 0.62, and 0.65). The SC-PCS total score moderately or weakly (R = −0.2 to 0.49), but significantly, correlated with other measurements, such as pain Visual Analog Scale, Beck Depression Inventory, Pain Anxiety Symptoms Scales, Positive and Negative Affect Schedule, and education. We used exploratory factor analysis to examine the dimensionality of the SC-PCS, which indicated instability of the current three-factor model. However, a confirmatory factor analysis indicated that the three-factor model had the best goodness-fitting.ConclusionsWe demonstrate the successful translational adaptation from English to Simplified Chinese as well as the reliability and validity of SC-PCS. An important discovery was education level significantly correlated with SC-PCS, identifying a future consideration for other cross-cultural development of self-reported measures.

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

“…However, we obtained lower alpha coe cients for the rumination (α = 0.69) and magni cation (α = 0.41) subscales but su cient for the helplessness subscale (α = 0.78). Consistent with our ndings, most previous studies [37,40,43,76,82] found lower alpha coe cients for the magni cation subscales, which could be attributed to the small number of items peculiar with the three-factor structure. It is important to note that increasing the number of scale items typically increases the Cronbach's alpha [86].…”

“…Additionally, the CFA suggests that the three-factor structure had the best t for our sample compared to the one-factor or two-factor structure obtained for the English version as indicated by a low SRMR and RMSEA and high CFI and TLI. 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].…”

“…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].…”

Factor structure and internal consistency of a Swedish version of the Pain Catastrophizing Scale

“…In its original format the PCS comprises 13 items that are rated from 0 to 4 with the endpoints 0 (“Never”) to 4 (“All the time”). Repeatedly, results from previous studies illustrate that pain catastrophizing as assessed by the PCS comprise three factors labeled: (a) Helplessness , which pertains to the helplessness felt in situations when pain is present; (b) Rumination , that concerns the tendency to be increasingly vigilant toward pain; and (c) Magnification , which captures the tendency to exaggerate the threat value of pain . In the original study by Sullivan, were the oblique three‐factor model was proposed, the correlation between the three subscales was moderate, and the internal consistency was adequate as represented by a Cronbach's α of 0.87 for the total scale.…”

“…The subjective psychological experiences and accompanying behaviors that constitute catastrophizing are most commonly assessed with self‐report measures, and the Pain Catastrophizing Scale (PCS) is one of the most widely used questionnaires. The PCS has been validated in a number of languages and for a number of pain populations for adults . However, thus far, no study has evaluated the validity and reliability of a Swedish version of the scale.…”