Validation of the Dutch Version of the Breakthrough Pain Assessment Tool in Patients With Cancer

Abstract

Context. Essential for adequate management of breakthrough cancer pain is a combination of accurate (re-)assessment and a personalized treatment plan. The Breakthrough Pain Assessment Tool (BAT) has been proven to be a brief, multidimensional, reliable, and valid questionnaire for the assessment of breakthrough cancer pain.Objectives. The aim of this study was to examine the validity and reliability of the Dutch Language version of the BAT (BAT-DL) in patients with cancer.Methods. The BAT was forward-backward translated into the Dutch language. Thereafter, the psychometric properties of the BAT-DL were tested, that is factor structure, reliability (internal consistency and test-retest reliability), validity (content validity and construct validity), and the responsiveness to change.Results. The BAT-DL confirmed the two-factor structure in 170 patients with cancer: pain severity/impact factor and pain duration/medication efficacy factor. The Cronbach's alpha coefficient was 0.72, and the intraclass correlation for the testretest reliability was 0.81. The BAT-DL showed to be able to differentiate between different group of patients and correlated significantly with the Brief Pain Inventory. In addition, the BAT-DL was capable to detect clinically important changes over time.Conclusion. The BAT-DL is a valid and reliable questionnaire to assess breakthrough pain in Dutch patients with cancer and is a relevant questionnaire for daily practice.

Cultural adaptation and psychometric validation of the Portuguese breakthrough pain assessment tool with cancer patients

“…Drawing upon previous data [11][12][13], we expected good levels of internal consistency for the total scale and its severity and impact subscale but fair levels for the duration and medication efficacy subscale (Hypothesis 2). Third, to assess the instrument's convergent validity, we tested the hypothesis that more severe and incapacitating BTcP episodes would be associated with more severe and incapacitating overall pain (Hypothesis 3), an association found in previous studies [4,[11][12][13]. Finally, as for BAT-Pt's criterion (concurrent) validity, we expected that BAT-Pt scores would be associated with physical but also psychological outcomes.…”

“…First, we sought to investigate BAT-Pt's factorial structure by conducting a Principal Axis Factor Analysis. We expected to find the two dimensions reported in previous studies (Hypothesis 1) [11][12][13]. Second, we aimed to test BAT-Pt's internal consistency.…”

“…It taps into multiple specific dimensions of BTcP, namely, its severity and impact on daily life (dimension 1) and duration and medication efficacy (dimension 2). Its original psychometric study conducted in the United Kingdom [11] and the adaptation and validation studies for the Korean [12] and Dutch [13] populations have shown that the BAT has good psychometric qualities across these different cultures. In all three studies the BAT presented the expected two-factor structure, showed good levels of internal consistency and temporal stability for the total scale and its severity and impact subscale and fair levels of reliability for its duration and medication efficacy subscale [11][12][13].…”

“…Its original psychometric study conducted in the United Kingdom [11] and the adaptation and validation studies for the Korean [12] and Dutch [13] populations have shown that the BAT has good psychometric qualities across these different cultures. In all three studies the BAT presented the expected two-factor structure, showed good levels of internal consistency and temporal stability for the total scale and its severity and impact subscale and fair levels of reliability for its duration and medication efficacy subscale [11][12][13]. The BAT has also shown good validity by differentiating patients based on their clinical characteristics, mostly physical outcomes such as levels of overall pain, medication dosage, disease progression and physical functioning [11-This is a post-print version of a manuscript published in the Scandinavian Journal of Painhttps://doi.org/10.1515/sjpain-2021-0002 5 13].…”

“…Finally, as for BAT-Pt's criterion (concurrent) validity, we expected that BAT-Pt scores would be associated with physical but also psychological outcomes. More specifically, more severe and incapacitating BTcP episodes would be associated with higher levels of functional disability [11][12][13] This is a post-print version of a manuscript published in the Scandinavian Journal of Painhttps://doi.org/10.1515/sjpain-2021-0002 6 (Hypothesis 4) and worse BAT-Pt scores would be associated with patient-and physiciandetermined adequacy of BTcP control [11][12][13] (Hypothesis 5), and increased distress, anxiety and depression [6][7][8][9][10]15] (Hypothesis 6). This is a post-print version of a manuscript published in the Scandinavian Journal of Painhttps://doi.org/10.1515/sjpain-2021-0002 7…”