Phoon Ping Chen

Validation of the Chinese Pain Catastrophizing Scale (HK‐PCS) in Patients with Chronic Pain

OBJECTIVEnThis study was conducted to examine the psychometric properties of a Chinese translation of the Pain Catastrophizing Scale (HK-PCS).nnnDESIGN/PATIENTSnPatients aged 18-79 years (N = 130) with chronic nonmalignant pain attending an outpatient multidisciplinary pain center in Hong Kong participated in this cross-sectional study.nnnMETHODnSubjects completed a set of health-related instruments: HK-PCS, Hospital Anxiety and Depression Scale, Roland Morris Disability Questionnaire, SF-36 Health Survey, and a general demographic questionnaire. Data were analyzed for the distribution, internal consistency, reliability, and construct validity.nnnRESULTSnA satisfactory internal consistency was found (alpha = 0.927). The item-total correlation coefficients ranged from 0.575 to 0.777. The intraclass correlation coefficient was 0.969 for the total HK-PCS score, 0.956 for helplessness, 0.945 for magnification, and 0.910 for rumination. Confirmatory factor analysis verified a second-order factor structure with the comparative fit index = 1.00, root mean square error of approximation = 0.038, and normed fit index = 0.99 (chi(2) ((58)) = 68.84, P = 0.16). Significant correlations were found for pain intensity, disability, anxiety, and depression (r = 0.223-0.597, P < 0.01). The general health, social function, role emotional, and mental health domains of the SF-36 consistently demonstrated negative association with catastrophizing across all HK-PCS scores (r =-0.279 to -0.396, P < 0.01). No gender difference was noted for HK-PCS scores (P > 0.05), which is contrary to the existing literature.nnnCONCLUSIONnThis study has illustrated satisfactory psychometric properties of the HK-PCS. We provide evidence for the validity and reliability of the HK-PCS as an instrument for measuring pain catastrophizing in the Chinese patient with chronic pain.

Validation of the Chinese Version of Pain Self-efficacy Questionnaire

BACKGROUND:Self-efficacy is a person’s belief in his or her ability to perform a certain behavior that achieves a desired outcome. Belief in self-efficacy influences the use of pain-coping strategies, physical and psychological function, and rehabilitation outcome in chronic pain patients. We conducted this prospective study to validate the psychometric properties of a Chinese version of the Pain Self-Efficacy Questionnaire (PSEQ-HK). METHODS:A previously translated PSEQ-HK was evaluated with the author’s consent. Forward–backward translation was conducted, followed by critical appraisal by an expert panel. Reliability was examined by completing the PSEQ-HK twice over a 1-wk interval. One-hundred-twenty Chinese patients with chronic nonmalignant pain were asked to self-complete a set of health-related instruments in Chinese: Numeric Pain Rating Scale, Hospital Anxiety and Depression Scale, Roland–Morris Disability Questionnaire, Pain Catastrophizing Scale, and Medical Outcome Study Short-Form 36 (SF36) Health Survey. RESULTS:PSEQ-HK had good retest reliability (intraclass correlation coefficient 0.75) and high internal consistency (Cronbach’s &agr; 0.93). Exploratory factor analysis showed a one-factor model that accounted for 61% of the total variance, with minimal factor loading of 0.69. It was significantly correlated with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and five domains of SF36 (bodily pain, vitality, social functioning, role emotion, and mental health). Moderate correlations were observed with Roland–Morris Disability Questionnaire and two domains of SF36 (role physical, general health). It had no correlation with pain score and medication use. CONCLUSIONS:PSEQ-HK is a reliable Chinese clinical assessment tool with satisfactory psychometric properties. Our results provided preliminary support for the construct validity of PSEQ-HK in a heterogeneous Chinese population with chronic nonmalignant pain.

The costs and benefits of extending the role of the acute pain service on clinical outcomes after major elective surgery.

BACKGROUND:Acute pain services have received widespread acceptance and formal support from institutions and organizations, but available evidence on their costs and benefits is scarce. Although there is good agreement on the provision of acute pain services after many major surgical procedures, there are other procedures for which the benefits are unclear. Data are required to justify any expansion of acute pain services. In this randomized, controlled clinical trial we compared the costs and effects of acute pain service care on clinical outcomes with conventional pain management on the ward. Patients included in the trial were considered by their anesthesiologist to have either arm be suitable for the procedure. METHODS:Four hundred twenty-three patients undergoing major elective surgery were randomized either to an anesthesiologist-led, nurse-based acute pain service group with patient-controlled analgesia or to a control group with IM or IV boluses of opioid analgesia. Both groups were treated with medications to treat opioid-related adverse effects and received the usual care from health professionals assigned to the ward. The main outcome measures were quality of recovery scores, pain intensity measures, global measure of treatment effectiveness, and overall pain treatment cost. Cost-effectiveness acceptability curves were drawn to detect a difference in the joint cost-effect relationship between groups. RESULTS:There was no difference in quality of recovery score on postoperative day 1 between treatment and control groups (mean difference, 0; 95% confidence interval [CI], −0.7 to 0.7; P = 0.94) or in the rate of improvement in quality of recovery score (mean difference, −0.1; 95% CI, −0.4 to 0.1; P = 0.34). The proportion of patients with 1 or more days of highly effective pain management was higher in the acute pain service group than in the control group (86% vs. 75%; P < 0.01). Costs were higher in the acute pain service group (mean difference, US

Chronic pain and psychiatric morbidity: a comparison between patients attending specialist orthopedics clinic and multidisciplinary pain clinic.

46; 95% CI,

The effect of intra-operative video on patient anxiety

44 to

The Chinese version of the 8-item Committed Action Questionnaire (ChCAQ-8): A preliminary analysis of the factorial and criterion validity.

48 per patient; P < 0.001). A cost-effectiveness acceptability curve showed that the acute pain service was more cost effective than was control for providing highly effective pain management if the decision maker was willing to pay more than US

Intravascular migration of epidural catheter during cesarean section.

546 per patient per 1 day with highly effective treatment. CONCLUSION:In extending the role of the acute pain service to a specific group of major surgical procedures, the acute pain service was likely to be cost effective.

The Reliability and Validity of the Cantonese Version of the Pain Treatment Satisfaction Scale (ChPTSS) in a Sample of Chinese Patients with Chronic Pain

OBJECTIVEnThe objective of this study was to examine the associations between chronic pain and psychiatric morbidity using interview-based assessments of psychiatric symptomatology. We compared the prevalence of common mental disorder (CMD; consistent with neurotic and somatic symptoms, fatigue, and negative affect), depression, and anxiety disorder(s), and associated factors with these psychiatric illnesses among Chinese patients with chronic pain attending specialist orthopedics clinic and multidisciplinary pain clinic.nnnMETHODSnA total of 370 patients with chronic pain were recruited from an Orthopedics Clinic (N=185) and a Pain Clinic (N=185) in Hong Kong. Psychiatric morbidity was assessed using the Revised Clinical Interview Schedule. Individual scores for neurotic symptoms and neurotic disorders (including depression and four types of anxiety disorders) were also calculated.nnnRESULTSnThe reported lifetime prevalence rates of CMD were 35.3% and 75.3% for the Orthopedics and Pain Clinic samples, respectively. Rates of depression and anxiety disorders in the Pain Clinic (57.1% and 23.2%, respectively) were significantly higher than those in the Orthopedics sample (20.2% and 5.9%, respectively) (all P<0.001). Pain characteristics including number of pain sites, pain duration, pain intensity, and pain interference were all significantly associated with psychiatric morbidity after controlling for sociodemographic factors. Pain duration and litigation/compensation status consistently predicted concurrent pain intensity and disability.nnnCONCLUSIONSnChronic pain is associated with psychiatric morbidity. The higher rate of depression than anxiety disorder(s) among patients with chronic pain is consistent with previous studies that have found depression to be highly prevalent in chronic pain.

Pain management programme for Chinese patients: a 10-year outcome review.

Summary We conducted a randomised controlled study to evaluate whether watching video compact discs intra‐operatively using a liquid crystal display (LCD) unit decreased anxiety. Forty‐four patients undergoing elective surgery under regional anaesthesia were assigned to either the LCD or control group. Anxiety was measured using the Chinese version of the State‐Trait Anxiety Inventory (STAI) and visual analogue score (VAS). The mean (SD) anxiety trait scores were 46.15 (6.28) and 46.40 (7.32) in the control and LCD groups, respectively. The state anxiety of the LCD group [35.50 (7.96)] measured immediately postoperatively was significantly lower than the control group [41.50 (9.02); p = 0.03]. The median (range) reduction in VAS anxiety score was not significantly greater in the LCD group [20 (−20 to 80)u2003mm] compared with the control group [12.5 (−70 to 60)u2003mm]. Watching video intra‐operatively reduces patient anxiety as measured by the STAI.

The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model

Committed action is a key component of the psychological flexibility model that recently has been applied in chronic pain settings. Developed within the Western context, the 8-item Committed Action Questionnaire (CAQ-8) demonstrated good psychometric properties. This study aimed to translate the original English version of the CAQ-8 into Chinese (ChCAQ-8) and to assess its reliability, factor structure and concurrent criterion validity. A total of 210 Chinese patients with chronic pain completed the ChCAQ-8, the Chronic Pain Grade, the Pain Catastrophizing Scale, and the depression subscale of the Hospital Anxiety and Depression Scale. Results of confirmatory factor analysis showed both the 2-factor correlated (CFI = .99) and hierarchical (CFI = .98) models met the minimum acceptable fit criterion. The 2 subscales and the entire scale of ChCAQ-8 demonstrated good internal consistency (Cronbachs αs ranging .70-.86). The ChCAQ-8 negative subscale score was significantly correlated with pain intensity, disability, pain catastrophizing, and depression in the expected direction. The ChCAQ-8 positive subscale was significantly correlated with pain castastrophizing and depression. Results of multivariate regression modeling showed the ChCAQ-8 negative subscale predicted depression (std β = .19, p < .01) and disability (std β = .14, p < .05), after adjusting for pain intensity, pain duration and pain catastrophizing. Our findings offer preliminary data for the reliability, factorial and concurrent criterion validity of the ChCAQ-8 in the Chinese population. (PsycINFO Database Record