Measurement Properties of the Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) in Pain-related Musculoskeletal Conditions: A Systematic Review

OBJECTIVE

The objective of this study was to systematically locate, critically appraise, and summarize clinical measurement research addressing the use of Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) in pain-related musculoskeletal (MSK) conditions.

MATERIALS AND METHODS

We systematically searched 4 databases (Medline, CINAHL, EMBASE, and SCOPUS) and screened articles to identify those reporting the psychometric properties (eg, validity, reliability) and interpretability (eg, minimal clinically important difference) of BPI-SF and SF-MPQ-2 as evaluated in pain-related MSK conditions. Independently, 2 reviewers extracted data and assessed the quality of evidence with a structured quality appraisal tool and the updated COSMIN guidelines.

RESULTS

In all, 26 articles were included (BPI-SF, n=17; SF-MPQ-2, n=9). Both tools lack reporting on their cross-cultural validities and measurement error indices (eg, standard error of measurement). High-quality studies suggest the tools are internally consistent (α=0.83 to 0.96), and they associate modestly with similar outcomes (r=0.3 to 0.69). Strong evidence suggests the BPI-SF conforms to its 2-dimensional structure in MSK studies; the SF-MPQ-2 4-factor structure was not clearly established. Seven reports of high-to-moderate quality evidence were supportive of the BPI-SF known-group validity (n=2) and responsiveness (n=5). One report of high quality established the SF-MPQ-2 responsiveness.

DISCUSSION

Evidence of high-to-moderate quality supports the internal consistency, criterion-convergent validity, structural validity, and responsiveness of the BPI-SF and SF-MPQ-2 and establishes their use as generic multidimensional pain outcomes in MSK populations. However, more studies of high quality are still needed on their retest reliability, known-group validity, cross-cultural validity, interpretability properties, and measurement error indices in different MSK populations.

Reproducibility: Reliability and Agreement Parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in Patients with Musculoskeletal Shoulder Pain

Background: The Revised Short-Form McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to evaluate neuropathic and nonneuropathic pain. A recent systematic review found insufficient psychometric data with respect to musculoskeletal health conditions.

Aims: The aim of this study was to describe the reproducibility (reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain.

Methods: Eligible patients with shoulder pain from musculoskeletal (MSK) sources completed the SF-MPQ-2 at baseline (n = 195), and a subset did so again after 3 to 7 days (n = 48) if their response to the global rating of change scale remained unchanged. Cronbach’s alpha (α) and intraclass correlation coefficient (ICC[2,1]) were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland-Altman plots were used to assess agreement.

Results: Cronbach’s α ranged from 0.83 to 0.95, suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC(2,1) scores were found in support of the total (0.95) and continuous (0.92) subscales; the remaining subscales displayed good ICC(2,1) scores (0.78–0.88). Bland-Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13 to 0.19). Though the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90 = 1.2, MDC90_group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range, 0.7–1; MDC90: range, 1.7–2.3; MDC90_group: range, 0.4–0.5).

Conclusions: The SF-MPQ-2 provides good to excellent test–retest reliability for multidimensional pain assessment among patients with musculoskeletal shoulder pain conditions.

Measurement Properties of the Brief Pain Inventory-Short Form (BPI-SF) and the Revised Short McGill Pain Questionnaire-Version-2 (SF-MPQ-2) in Pain-related Musculoskeletal Conditions: A Systematic Review Protocol

Background

The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short-Form McGill Pain Questionnaire Version-2 (SF-MPQ-2) are generic pain assessment tools used in research and practice for pain assessment in musculoskeletal (MSK) conditions. A comprehensive review that systematically analyses their measurement properties in MSK conditions has not been performed. This review protocol describes the steps that will be taken to locate, critically appraise, compare and summarize clinical measurement research on the BPI-SF and SF-MPQ-2 in pain-related MSK conditions.

Methods

Medline, EMBASE, CINAHL and Scopus will be searched for publications that examine the measurement properties of the Brief Pain Inventory and Revised Short-Form McGill Pain Questionnaire Version-2. Two reviewers will independently screen citations (title, abstract and full text) and extract relevant data. The extensiveness, rigor, and quality of measurement property reports will be examined with a structured measurement studies appraisal tool, and with the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Findings will be descriptively summarized, and when possible, a meta-analysis will be performed.

Discussion

This review will summarize and compare the current level of evidence on the measurement properties of the BPI-SF and SF-MPQ-2 in a spectrum of musculoskeletal conditions. We expect clinicians/researchers dealing with MSK conditions to have synthesized evidence that informs their decision making and preferences. In addition, the review hopes to identify gaps and determine priorities for future research with or on the BPI-SF and SF-MPQ-2 in MSK conditions.

The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria

INTRODUCTION

The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers.

OBJECTIVES

To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles.

METHOD

This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis.

RESULTS

The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants.

CONCLUSIONS

Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.