Further Development of the Multidimensional Pain Readiness to Change Questionnaire: The MPRCQ2

Abstract

This study describes further development of the Multidimensional Pain Readiness to Change Questionnaire (MPRCQ2), a measure of readiness to adopt a variety of pain management and coping strategies commonly taught in multidisciplinary treatment programs. Clinical samples were recruited from a Fibromyalgia Day Program (n = 139) and an Arthritis Day Program (n = 51) as well as 2 survey samples with pain resulting from either a spinal cord injury (n = 127) or an amputation (n = 120). The results indicate preliminary support for the reliability and validity of the MPRCQ2. The MPRCQ2 may be helpful in future research investigating the relationship between readiness to change pain-related coping and adoption of coping behaviors and adjustment to chronic pain.Perspective-This study describes the development of a revised version of the MPRCQ, the MPRCQ2, in 4 patient samples. The results support the reliability and validity of the MPRCQ2 in individuals with fibromyalgia syndrome, arthritis, acquired amputation, and spinal cord injury and improve on some aspects of the instrument. KeywordsChronic pain; readiness to change; Multidimensional Pain Readiness to Change Questionnaire Although multidisciplinary treatment programs for patients with chronic pain have been shown to be effective, 4,20 not all patients appear to benefit equally. 26 The extent to which patients adopt pain management coping strategies proffered by such programs has been cited as one explanation for these individual differences. 29 The Transtheoretical Model (TTM) of behavioral change [22][23] and the "stages of change" concept in particular have been suggested as a theoretical schema that may help explain why some individuals benefit and others do not. 14 The Pain Stages of Change Questionnaire (PSOCQ 16 ), informed by the TTM, has been developed to assess overall readiness to self-manage pain. Accumulating evidence suggests that readiness to self-manage pain, as assessed by the PSOCQ scales, is associated with coping NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript and adjustment to chronic pain and that increased commitment to a self-management approach may mediate improved outcomes during pain self-management treatment. [2][3][4][5][6][7][8][9]14 There is also evidence to suggest that classifying patients into discrete stages of pain-related readiness to change may have theoretical and practical limitations. 5,10,25 In the broader health behavior literature, the "stage" concept has also been directly challenged. 1,17 In short, the available evidence does not support the conclusion that individuals necessarily proceed through discrete stages of adaptation in a fixed sequence. However, the key idea that individuals may vary in their "readiness" to adopt new coping behaviors has not been criticized. Patient variation along a readiness continuum may be a key element in understanding how patients benefit or fail to benefit from multidisciplinary treatment programs. 8 Indeed, there is evidence to suggest that PSOCQ score...

Physical pain, common psychiatric and substance use disorders, and the non-medical use of prescription analgesics in the United States

“…Pain is usually categorized by its course, such as acute or chronic, and can be further subdivided into region (e.g., chronic back pain, cancer, non-cancerous pain). It is also a wholly subjective phenomenon, and there are numerous pain-related assessment scales that measure intensity using different question forms, such as numerical, verbal, or visual aids (Jensen, 2006; Nielson et al, 2008). Given that there is no clear consensus on the best measurement of pain, we are unable to comment on how our results would be affected if another rating scale were used.…”

Further Evaluation of the Motivational Model of Pain Self-Management: Coping with Chronic Pain in Multiple Sclerosis

“…These data also indicate that two subscales taken from the Multidimensional Pain Readiness to Change Questionnaire 2 [39], a measure of the readiness to begin using pain-coping strategies, can be effectively used to test the Motivational Model of Pain Self-Management. In addition to exercise and task persistence (tested in this study), the Multidimensional Pain Readiness to Change Questionnaire 2 measures readiness to adopt an additional seven pain self-management strategies—relaxation, cognitive control, avoiding asking for assistance, pacing, avoiding rest, assertiveness, and body mechanics.…”

“…Motivational interviewing strategies can also be used to help patients resolve ambivalence about changing behavior and to address perceived barriers to behavior change [39]. For example, one strategy used in motivational interviewing is to elicit and reinforce positive statements about one’s ability to engage in behavior change.…”

“…The revised version of the Multidimensional Pain Readiness to Change Questionnaire 2 [39], a 69-item measure that assesses willingness to use or not use nine pain-coping responses, including exercise (seven items) and task persistence (five items), was used in the present study. The Multidimensional Pain Readiness to Change Questionnaire 2 Exercise and Task Persistence scales have demonstrated adequate to excellent reliability across different samples of patients with chronic pain (overall alpha coefficients of 0.85 and 0.77, respectively) [36].…”

A Cross‐Cultural Validation of the Multidimensional Pain Readiness to Change Questionnaire 2 for Japanese Individuals With Chronic Pain

“…The PSOCQ has 4 scales corresponding to each of these change stages. However, 2 shortcomings of the PSOCQ have been identified . First, the idea of discrete stages as hypothesized by the Pain Readiness to Change Model and reflected by the PSOCQ scales is not consistent with the finding that individuals with chronic pain cannot be clearly classified into a specific change stage .…”