Development of the Italian version of the 42-item Chronic Pain Coping Inventory, CPCI-I: cross-cultural adaptation, factor analysis, reliability and validity

Active elderly and health-can moderate exercise improve health and wellbeing in older adults? Protocol for a randomized controlled trial

Background

Aging is marked by a progressive rise in chronic diseases with an impact on social and healthcare costs. Physical activity (PA) may soothe the inconveniences related to chronic diseases, has positive effects on the quality of life and biological rhythms, and can prevent the decline in motor functions and the consequent falls, which are associated with early death and disability in older adults.

Methods

We randomized 120 over-65 males and females into groups of similar size and timing and will give each either moderate physical activity or cultural and recreational activities. Being younger than 65 years, inability to participate in physical activity for any medical reason, and involvement in a massive program of physical exercise are the exclusion criteria. The primary outcome measures are: quality of life, walking speed, and postural sway. Participants are tested at baseline, post-treatment, and 6-month (24 weeks) and 12-month (48 weeks) follow-ups.

Discussion

This study aims at improving the quality of life, wellness, and cognitive functioning in the elderly through a low-cost affordable program of moderate physical activity. Given the growing aging of the world population and the social and economic burden of disability in the elderly, our results might have a major impact on future practices.

Trial registration

ClinicalTrials.gov NCT03858114. Registered on 28 February 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05278-6.

Structural validity of the Chronic Pain Coping Inventory-Brazilian version

Background

The Chronic Pain Coping Inventory (CPCI) has been widely used to measure coping with pain, however, the psychometric properties of the Brazilian CPCI are unknown.

Aim

To verify the validity and reliability of the CPCI-Brazilian version.

Materials and methods

A sample of 705 outpatients with chronic pain participated in the study. Cronbach’s alpha, corrected item-total correlations, and confirmatory factor analysis were performed, using the method of Diagonally Weighted Least Squares.

Results

Construct validity was supported with a factor loading range of 0.36–0.90 (9 factors) corroborating original loads. The final model had adequate fit with items 42 and 54 excluded, D.F = 2174, TLI = 0.96; CFI = 0.96 and RMSEA = 0.051(p = 0.067). Eight of the nine CPCI scales showed satisfactory reliability (Cronbach’s alpha ranged from 0.70 to 0.92). The Relaxation scale obtained a low alpha value (0.53).

Conclusion

The CPCI-Brazilian version, after exclusion of items 42 and 54, is valid to measure chronic pain coping in Brazilian adults.

Efficacy of two brief cognitive-behavioral rehabilitation programs for chronic neck pain: results of a randomized controlled pilot study

BACKGROUND

Current models of pain behavior suggest that kinesiophobia prevents the reacquisition of normal function, promotes the development of maladaptive coping strategies, and contributes to the disability associated with chronic neck pain (NP).

AIM

Comparing two brief cognitive-behavioral programs aimed at managing kinesiophobia to understand which one induces better short-term improvements in disability, fear of movement, catastrophizing, adaptive coping strategies, quality of life (QoL), and pain intensity of chronic NP.

DESIGN

Pilot, randomized, controlled trial, 3-months follow-up.

SETTING

Outpatients.

POPULATION

Subjects with chronic NP.

METHODS

The population was randomized into two groups: group A (N.=15) underwent four sessions of cognitive-behavioral therapy (CBT) based on the NeckPix© (1-week duration); group B (N.=15) received four sessions of CBT based on the Tampa Scale of Kinesiophobia (TSK) (1-week duration). Afterwards, both groups attended 10 sessions of multimodal exercises (5-week duration). Primary measure: Neck Disability Index (NDI). Secondary measures: NeckPix©, TSK, Pain Catastrophizing Scale, Chronic Pain Coping Inventory, EuroQol-Five Dimensions, and pain intensity Numerical Rating Scale.

STATISTICS

Linear mixed model analyses for repeated measures for each outcome measure to evaluate changes over time and between group.

RESULTS

A significant effect of time was found for all outcomes, while no outcomes showed group and/or interaction effects. No changes were found in terms of NDI at the end of CBT, while a significant improvement of about 13 points was found for both groups at the end of the motor training (P=0.001). Similarly, in terms of quality of life there was no change after the CBT program, and a significant change at the end of the motor training, with a partial loss at follow-up. From CBT sessions to follow-up both groups showed a progressive reduction in kinesiophobia, with each group achieving a bigger change in the specific scale used for the CBT program.

CONCLUSIONS

Two brief cognitive-behavioral rehabilitation programs based on different methodologies of managing fear-avoidance beliefs induced similar short-term improvements in subjects with chronic NP. Clinically significant changes in terms of disability were found in both groups only at the end of a 5-week motor training, regardless of the cognitive-behavioral rehabilitation program previously administrated.

CLINICAL REHABILITATION IMPACT

Treatment of chronic NP requires cognitive modifications closely linked to physical performances in order to achieve mental adjustments and guarantee cognitive-behavioral as well as motor lasting changes.

The 27-item coping strategies questionnaire-revised: confirmatory factor analysis, reliability and validity in Italian-speaking subjects with chronic pain

BACKGROUND

Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain.

OBJECTIVE

To develop an Italian version of the Coping Strategies Questionnaire - Revised (CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain.

METHODS

The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile - Roland Scale), depression (Center for Epidemiological Studies - Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson's correlation).

RESULTS

Confirmatory factor analysis revealed that the CSQ-R model had an acceptable data-model fit (comparative fit index and normed fit index ≥0.90, root mean square error of approximation ≤0.08). Cronbach's alpha was satisfactory (CSQ-R 0.914 to 0.961), and the intraclass correlation coefficients were good⁄excellent (CSQ-R 0.850 to 0.918). As expected, the correlations with the numerical rating scale, Sickness Impact Profile - Roland Scale, Center for Epidemiological Studies - Depression Scale and Chronic Pain Coping Inventory highlighted the adaptive and maladaptive properties of most of the CSQ-R subscales.

CONCLUSION

The CSQ-R was successfully translated into Italian. The translation proved to have good factorial structure, and its psychometric properties are similar to those of the original and other adapted versions. Its use is recommended for clinical and research purposes in Italy and abroad.

The Italian version of the Pain Beliefs and Perceptions Inventory: cross-cultural adaptation, factor analysis, reliability and validity

PURPOSE

To create an Italian version of the Pain Beliefs and Perceptions Inventory (PBAPI-I) and evaluate its psychometric properties.

METHODS

The PBAPI was culturally adapted in accordance with international standards. The psychometric testing included factor analysis, investigating reliability by internal consistency (Cronbach's alpha) and test/retest stability (intraclass correlation coefficient, ICC), and exploring construct validity by comparing the PBAPI-I with a pain numerical rating scale (NRS), the Roland Morris Disability Questionnaire (RMDQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS) and the Chronic Pain Coping Inventory (Pearson's correlation).

RESULTS

One hundred and sixty-seven subjects with chronic low back pain (83 % compliance) completed the tool. Factor analysis revealed a three-factor (Time, Mystery and Self-Blame), 16-item solution (explained variance: 80 %). The questionnaire was internally consistent (α = 0.91-0.96), and its stability was good (ICCs = 0.73-0.82). As expected, the construct validity estimates indicated that the Time and Mystery subscales moderately correlated with the NRS (r = 0.33-0.54), RMDQ (r = 0.34-0.47), PCS (r = 0.37-0.49) and TSK (r = 0.30-0.43), whereas the correlations between the Self-Blame subscale and the same measures were poorer. The correlations with the HADS were moderate and poor (anxiety: r = 0.37-0.05; depression: r = 0.39-0.07). Maladaptive coping strategies were more related to pain beliefs than adaptive strategies.

CONCLUSION

The PBAPI-I has good psychometric properties that replicate those of other versions.