Assessment Tools of Patient Competences: The Spanish Version of the R-NPQ and Three Practical Cases in Women with Breast Cancer and Persistent Pain

Abstract

Persistent pain following treatment for breast cancer (PPBCT) is a prevalent and complex clinical issue. Education together with physiotherapy have been shown to lessen pain and disability in chronic pain. Although the evaluation of the patient’s competences is a major part of the educational program, the published educational programs rarely describe the tools used to assess competences, especially regarding those related to decision-making and problem-solving. The aim of this study was to provide two competences assessment tools: the cross-cultural adaptation and validation of the Spanish version of the Revised Neurophysiology of Pain Questionnaire (R-NPQ) and practical cases of women with PPBCT. The Spanish cross-cultural adaptation was conducted following recognized criteria. Measurement properties testing included an analysis of construct validity (known-groups approach), reliability (internal consistency and test-retest reliability), responsiveness, interpretability, and feasibility. To promote a tool that would allow evaluation of the educational program competences, a group of experts developed three cases extracted from real contexts by means of an iterative process. A total of 80 women with PPBCT (mean age 56 years) and 81 physiotherapy students (mean age 20 years) participated in the measurement properties analysis. The three developed cases were presented to the same 80 women with PPBCT before and after the educational program. As we expected, students showed a significantly higher score (p < 0.001) than did women with PPBCT in the R-NPQ questionnaire, with a large effect size (d = 2.49), demonstrating good construct validity. The Cronbach alpha was 0.90 (95% CI, 0.87–0.92) and the intraclass correlation coefficient was 0.82 (95% CI, 0.73–0.88). A large effect size (5.2) was found, as we expected, between baseline and post-treatment scores, suggesting adequate responsiveness. In addition, identifying and analyzing, decision making, communicating needs, knowing how to manage, and problem-solving skills were evaluated through the three practical cases. Most women (88.75%) reached the highest level in the assessment rubric of the proposed practical cases. The Spanish R-NPQ is a comprehensible, valid, reliable, and responsive tool for Spanish women with PPBCT. The practical cases are a useful competence assessment tool and were well accepted by women with PPBCT. Further studies are needed to investigate more competence assessment tools and to investigate whether the achievement of different levels of competences has an effect on health behaviors.

Effectiveness of Therapeutic Exercise and Patient Education on Cancer-Related Fatigue in Breast Cancer Survivors: A Randomised, Single-Blind, Controlled Trial with a 6-Month Follow-Up

“…The educational intervention, which included tools for the self-management of perceived pain, is another factor that may have contributed to the clinically relevant reduction in pain intensity observed in both groups, which was already evident at V1 and progressively improved until V3. Therapeutic education plays a fundamental role in the development and self-management of chronic pathologies, is associated with improvements in health-related quality of life, and enhances adherence to the guidelines and recommendations of health professionals [ 29 , 30 ]. In this sense, the high adherence to therapeutic education observed in this study (95% in the STE-G and 87.5% in the EU-G) could be related to the therapeutic education program delivered to all the women.…”

“…In this sense, the high adherence to therapeutic education observed in this study (95% in the STE-G and 87.5% in the EU-G) could be related to the therapeutic education program delivered to all the women. This program specifically focused on encouraging the communication between the physiotherapist and patients, autonomy, and the acquisition of abilities affecting perceived self-efficacy [ 29 , 30 , 37 ]. Furthermore, no participant was lost to follow-up.…”

“…Therapeutic education was imparted at the Physiotherapy in Women’s Health Research Unit of the University of Alcalá (Madrid, Spain). The patient therapeutic education for BC survivors suffering from fatigue and persistent pain contained specific content on healthy lifestyle habits and pelvic floor health (patient therapeutic education description can be found elsewhere) [ 29 , 30 ]. Patient therapeutic education was taught to all participants in small groups (6 women maximum).…”

Transcultural Adaptation and Psychometric Validation of the Spanish Version of the Pain Attitudes and Beliefs Scale for Physiotherapists

“…Our study utilised the Spanish version of the R-NPQ [ 51 ], which had already been translated and cross-culturally adapted for use with patients and PTs. This version demonstrated satisfactory psychometric properties (Cronbach’s alpha = 0.90; ICC = 0.82).…”

Effectiveness, cost-utility and physiological underpinnings of the FIBROWALK multicomponent therapy in online and outdoor format in individuals with fibromyalgia: Study protocol of a randomized, controlled trial (On&Out study)

“…- The Revised Neurophysiology of Pain Questionnaire (R-NPQ; Torres-Lacomba et al, 2021 ). The R-NPQ consists of 13 statements (True/False/I do not know) about pain neurophysiology and has been extensively used to assess pain biology knowledge.…”