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International Journal of Behavioral Medicine

Published in:

01-04-2016

Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity

Authors: Marco Monticone, Emilia Ambrosini, Barbara Rocca, Tiziana Nava, Erica Terragni, Cesare Cerri, Lance M McCracken

Published in: International Journal of Behavioral Medicine | Issue 2/2016

Abstract

Background

Growing attention is being given to cognitive-behavioural measures to improve interventions for spinal disorders. The Pain Vigilance and Awareness Questionnaire (PVAQ) has never been validated in Italian subjects with chronic low back pain (LBP).

Purpose

The purpose of this study is translating, culturally adapting and validating the Italian version of PVAQ (PVAQ-I).

Methods

A cross-sectional evaluation of the psychometric properties of the PVAQ-I on patients with chronic LBP was conducted. The questionnaire was culturally adapted in accordance with international standards. The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intra-class correlation coefficient, ICC); construct validity by comparing the PVAQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS), the Chronic Pain Acceptance Questionnaire (CPAQ), a Numerical Rating Scale of pain intensity (NRS) and the Oswestry Disability Questionnaire (ODI); and sensitivity to change by calculating the smallest detectable change.

Results

The PVAQ-I was administered to 131 subjects with chronic LBP (77 females, mean age of 48 ± 16 years, median symptoms duration of 12 months). Factor analysis confirmed a two-factor (passive awareness and active vigilance), 13-item solution, which led to an acceptable data-model fit. Internal consistency (α = 0.91) and test–retest reliability (ICC = 0.92) were good. As a priori hypothesized, construct validity showed moderate correlations between the PVAQ-I and PCS (r = 0.60), TSK (r = 0.44) and HADS-Anxiety (r = 0.53) and low correlations with HADS-Depression (r = 0.28), NRS (r = 0.28), ODI (r = 0.23) and CPAQ (r = −0.12). The smallest detectable change was 9.

Conclusion

The PVAQ was successfully translated into Italian and proved to have satisfactory psychometric properties. Its use is recommended for clinical and research purposes.

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McCracken LM. “Attention” to pain in persons with chronic pain: a behavioral approach. Behav Ther. 1997;28(2):271–84.CrossRef

McWilliams LA, Asmundson GJG. Assessing individual differences in attention to pain: psychometric properties of the Pain Vigilance and Awareness Questionnaire modified for a non-clinical pain sample. Personal Individ Differ. 2001;31(2):239–46.CrossRef

Roelofs J, Peters ML, Muris P, Vlaeyen JWS. Dutch version of the Pain Vigilance and Awareness Questionnaire: validity and reliability in a pain-free population. Behav Res Ther. 2002;40(9):1081–90.CrossRefPubMed

Roelofs J, Peters ML, McCracken L, Vlaeyen JWS. The pain vigilance and awareness questionnaire (PVAQ): further psychometric evaluation in fibromyalgia and other chronic pain syndromes. Pain. 2003;101(3):299–306.CrossRefPubMed

Esteve R, Ramírez-Maestre C, López-Martínez AE. Empirical evidence of the validity of the Spanish version of the pain vigilance awareness questionnaire. Int J Behav Med. 2013;20(1):59–68.CrossRefPubMed

McCracken LM. A contextual analysis of attention to chronic pain: what the patient does with their pain might be more important than their awareness or vigilance alone. J Pain Off J Am Pain Soc. 2007;8(3):230–6.CrossRef

Wong WS, McCracken LM, Fielding R. Factorial validity and reliability of the Chinese version of the Pain Vigilance and Awareness Questionnaire (ChPVAQ) in a sample of Chinese patients with chronic pain. Pain Med Malden Mass. 2011;12(7):1018–25.CrossRef

McCracken LM, Morley S. The psychological flexibility model: a basis for integration and progress in psychological approaches to chronic pain management. J Pain Off J Am Pain Soc. 2014;15(3):221–34.CrossRef

De Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide [Internet]. Cambridge: Cambridge University Press; 2011. [cited 2013 Dec 2], Available from: http://ebooks.cambridge.org/ebook.jsf?bid=CBO9780511996214.

10.

Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30(1):77–94.CrossRefPubMed

11.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–91.CrossRefPubMed

12.

Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for Patient-Reported Outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health J Int Soc Pharmacoeconomics Outcome Res. 2005;8(2):94–104.CrossRef

13.

Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRefPubMed

14.

Browne M, Cudeck R. Alternative ways of assessing model fit. Testing Structural Equation Models. Newbury Park: Sage: Bollen KA, Long JS; 1993. p. 263–73.

15.

Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55.CrossRef

16.

Monticone M, Baiardi P, Ferrari S, Foti C, Mugnai R, Pillastrini P, et al. Development of the Italian version of the Pain Catastrophising Scale (PCS-I): cross-cultural adaptation, factor analysis, reliability, validity and sensitivity to change. Qual Life Res Int J Qual Life Asp Treat Care Rehab. 2012;21(6):1045–50.CrossRef

17.

Monticone M, Giorgi I, Baiardi P, Barbieri M, Rocca B, Bonezzi C. Development of the Italian version of the Tampa Scale of Kinesiophobia (TSK-I): cross-cultural adaptation, factor analysis, reliability, and validity. Spine. 2010;35(12):1241–6.CrossRefPubMed

18.

Costantini M, Musso M, Viterbori P, Bonci F, Del Mastro L, Garrone O, et al. Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 1999;7(3):121–7.

19.

Monticone M, Ferrante S, Rocca B, Nava T, Parini C, Cerri C. Chronic pain acceptance questionnaire: confirmatory factor analysis, reliability, and validity in Italian subjects with chronic low back pain. Spine. 2013;38(13):E824–31.CrossRefPubMed

20.

Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30(11):1331–4.CrossRefPubMed

21.

Monticone M, Baiardi P, Ferrari S, Foti C, Mugnai R, Pillastrini P, et al. Development of the Italian version of the Oswestry Disability Index (ODI-I): a cross-cultural adaptation, reliability, and validity study. Spine. 2009;34(19):2090–5.CrossRefPubMed

22.

Asmundson G, Norton P, Vlaeyen J. In: Asmundson GJG, Vlaeyen JWS, Crombez G, editors. Fear-avoidance models of chronic pain: an overview. Understanding and treating fear of pain. Oxford: Oxford University Press; 2004. p. 3–24.

23.

Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32.CrossRefPubMed

Title: Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity
Authors: Marco Monticone
Emilia Ambrosini
Barbara Rocca
Tiziana Nava
Erica Terragni
Cesare Cerri
Lance M McCracken
Publication date: 01-04-2016
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 2/2016
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-015-9507-x

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Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity

Abstract

Background

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusion

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