Development and Preliminary Psychometric Testing of the Centrality of Pain Scale

Abstract

Objective To develop and begin to evaluate a new measure of the centrality of pain in patients’ lives. Design Cross-sectional survey and cognitive interviews. Setting Academic general internal medicine clinic. Patients 65 adult internal medicine patients with chronic non-malignant pain (CNMP). Outcome measures We assessed content validity and clarity of the 10-item Centrality of Pain Scale (COPS) by soliciting feedback from chronic pain experts and by conducting cognitive interviews with patients with CNMP. We assessed internal consistency reliability using Cronbach’s alpha. We assessed construct validity by comparing the COPS with other measures of chronic pain morbidity including pain severity, depression, anxiety, physical and mental health function, PTSD, quality of life, and provider assessment. Results Healthcare providers felt the COPS had excellent face validity. Cognitive interviews revealed that patients’ understanding of the items matched the intended construct, the scale measured an important concept, and items were easy to understand. The COPS had excellent internal consistency (alpha=0.9). COPS was negatively associated with age (r=−0.29; p=0.02), but not with other demographic characteristics. Higher COPS scores were associated with poorer physical (r=−0.48; p<0.001) and mental (r=−0.39 ; p=0.002 ) health function, quality of life (r=−0.36; P=0.004) and provider assessment of stability (r=−0.38; p=0.004) as well as with greater pain grade (r=0.55; p<0.001) and depression (r=0.63; p<0.001). In multivariate analyses, age, physical and mental health function, and depression were independently associated with COPS. Conclusions The COPS has excellent internal consistency and construct validity. Additional studies are needed to further validate the scale.

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

“…The scale was developed following repeated clinical observations that patients appear to identify themselves strongly as "a pain patient" and view their pain as intractable. It is theorized that these beliefs might serve as a barrier to treatment response, and preliminary findings support this notion [37].…”

“…Scores range from 10 to 50, with higher scores indicating more pain centrality. This new scale has shown promising psychometric properties, with excellent internal consistency and construct validity [37]. Centrality of pain is of particular interest given its potential for impacting pain outcomes [37].…”

“…The study assessed pain centrality, a new construct that signifies the degree to which the experience of chronic pain is central to a respondent's life and identity [37]. The Centrality of Pain Scale [37] is 10-item selfreport measure with items such as "My pain defines who I am," "I think about pain all the time," and "My life revolves around my pain."…”

“…This new scale has shown promising psychometric properties, with excellent internal consistency and construct validity [37]. Centrality of pain is of particular interest given its potential for impacting pain outcomes [37]. The scale was developed following repeated clinical observations that patients appear to identify themselves strongly as "a pain patient" and view their pain as intractable.…”

“…The Centrality of Pain Scale [37] is 10-item selfreport measure with items such as "My pain defines who I am," "I think about pain all the time," and "My life revolves around my pain." Scores range from 10 to 50, with higher scores indicating more pain centrality.…”