Advertisement
Original Report| Volume 16, ISSUE 7, P645-656, July 2015

Psychometric Properties of the Pain Stages of Change Questionnaire: New Insights on the Measurement of Readiness to Change in Adolescents, Mothers, and Fathers

      Highlights

      • Cross-validation of the Pain Stages of Change Questionnaire–Adolescent and –Parent versions was supported.
      • Factor structures differed for parents (4 factors) and adolescents (3 factors).
      • Father data showed good reliability, and patterns were similar to mother data.
      • Parent and adolescent versions may tap different aspects of readiness to change.

      Abstract

      There is increasing interest in the measurement of “readiness to change,” or willingness to engage in a self-management approach to pain coping, as a predictor of treatment response in pediatric pain populations. The primary aim of the present study was to provide cross-validation of the Pain Stages of Change Questionnaire–Adolescent and –Parent versions in a new, independent pediatric chronic pain sample by examining aspects of reliability, validity, and generalizability of the factor structures identified in the initial validation study. Secondary aims were to 1) expand upon previously identified differences between the Pain Stages of Change Questionnaire–Adolescent and –Parent versions and 2) examine previously unreported aspects of father data. Although slight differences emerged, the factor structures identified in the initial validation were largely replicated, suggesting that the psychometric properties of the measure are robust across pediatric outpatient chronic pain samples. Variability between parent and adolescent reports suggests that there may be meaningful differences in the interpretation of each measure and that factors other than readiness to change may influence response patterns. Findings highlight the need for more fine-tuned analyses of the way the construct operates in youth with pediatric pain and their parents.

      Perspective

      Findings provide further validation of the Pain Stages of Change Questionnaire–Adolescent and –Parent versions measures in a new outpatient pediatric chronic pain sample. Previously uninvestigated father data showed good reliability and patterns of findings similar to validated mother reports. Moreover, the study suggests that the adolescent and parent versions may function in meaningfully different ways.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bentler P.M.
        Comparative fit indexes in structural models.
        Psychol Bull. 1990; 107: 238-246
        • Birmaher B.
        • Brent D.A.
        • Chiappetta L.
        • Bridge J.
        • Monga S.
        • Baugher M.
        Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study.
        J Am Acad Child Adolesc Psychiatry. 1999; 38: 1230-1236
        • Carr J.L.
        • Moffett J.A.
        • Sharp D.M.
        • Haines D.R.
        Is the Pain Stages of Change Questionnaire (PSOCQ) a useful tool for predicting participation in a self-management programme? Further evidence of validity, on a sample of UK pain clinic patients.
        BMC Musculoskelet Disord. 2006; 7: 101
        • Cohen L.L.
        • Vowles K.E.
        • Eccleston C.
        Adolescent chronic pain-related functioning: Concordance and discordance of mother-proxy and self-report ratings.
        Eur J Pain. 2010; 14: 882-886
        • Cohen L.L.
        • Vowles K.E.
        • Eccleston C.
        The impact of adolescent chronic pain on functioning: Disentangling the complex role of anxiety.
        J Pain. 2010; 11: 1039-1046
        • Crombez G.
        • Bijttebier P.
        • Eccleston C.
        • Mascagni T.
        • Mertens G.
        • Goubert L.
        • Verstraeten K.
        The Child version of the Pain Catastrophizing Scale (PCS-C): A preliminary validation.
        Pain. 2003; 104: 639-646
        • Cunningham N.R.
        • Lynch-Jordan A.
        • Mezoff A.G.
        • Farrell M.K.
        • Cohen M.B.
        • Kashikar-Zuck S.
        Importance of addressing anxiety in youth with functional abdominal pain: Suggested guidelines for physicians.
        J Pediatr Gastroenterol Nutr. 2013; 56: 469-474
        • Eccleston C.
        • Scotford A.
        • Clinch J.
        • Connell H.
        Experiences of fathers of adolescents with chronic pain.
        Ann Rheum Dis. 2004; 63: 430-431
        • Goubert L.
        • Eccleston C.
        • Vervoort T.
        • Jordan A.
        • Crombez G.
        Parental catastrophizing about their child's pain. The parent version of the Pain Catastrophizing Scale (PCS-P): A preliminary validation.
        Pain. 2006; 123: 254-263
        • Guite J.W.
        • Logan D.E.
        • Ely E.A.
        • Weisman S.J.
        The ripple effect: systems-level interventions to ameliorate pediatric pain.
        Pain Manag. 2012; 2: 593-601
        • Guite J.W.
        • Logan D.E.
        • Simons L.E.
        • Blood E.A.
        • Kerns R.D.
        Readiness to change in pediatric chronic pain: Initial validation of adolescent and parent versions of the Pain Stages of Change Questionnaire.
        Pain. 2011; 152: 2301-2311
        • Hadjistavropoulos H.
        • Shymkiw J.
        Predicting readiness to self-manage pain.
        Clin J Pain. 2007; 23: 259-266
        • Hainsworth K.R.
        • Davies W.H.
        • Khan K.A.
        • Weisman S.J.
        Development and preliminary validation of the child activity limitations questionnaire: Flexible and efficient assessment of pain-related functional disability.
        J Pain. 2007; 8: 746-752
        • Holmbeck G.N.
        • Thill A.W.
        • Bachanas P.
        • Garber J.
        • Miller K.B.
        • Abad M.
        • Bruno E.F.
        • Carter J.S.
        • David-Ferdon C.
        • Jandasek B.
        • Mennuti-Washburn J.E.
        • O'Mahar K.
        • Zukerman J.
        Evidence-based assessment in pediatric psychology: Measures of psychosocial adjustment and psychopathology.
        J Pediatr Psychol. 2008; 33 (discussion 981-2): 958-980
        • Jastrowski Mano K.E.
        • Evans J.R.
        • Tran S.T.
        • Anderson Khan K.
        • Weisman S.J.
        • Hainsworth K.R.
        The psychometric properties of the screen for child anxiety related emotional disorders in pediatric chronic pain.
        J Pediatr Psychol. 2012; 37: 999-1011
        • Jastrowski Mano K.E.
        • Khan K.A.
        • Ladwig R.J.
        • Weisman S.J.
        The Impact of Pediatric Chronic Pain on Parents' Health-Related Quality of Life and Family Functioning: Reliability and Validity of the PedsQL 4.0 Family Impact Module.
        J Pediatr Psychol. 2011; 36: 517-527
        • Jensen M.P.
        • Nielson W.R.
        • Kerns R.D.
        Toward the development of a motivational model of pain self-management.
        J Pain. 2003; 4: 477-492
        • Jensen M.P.
        • Nielson W.R.
        • Romano J.M.
        • Hill M.L.
        • Turner J.A.
        Further evaluation of the pain stages of change questionnaire: Is the transtheoretical model of change useful for patients with chronic pain?.
        Pain. 2000; 86: 255-264
        • Kerns R.D.
        • Habib S.
        A critical review of the pain readiness to change model.
        J Pain. 2004; 5: 357-367
        • Kerns R.D.
        • Rosenberg R.
        • Jamison R.N.
        • Caudill M.A.
        • Haythornthwaite J.
        Readiness to adopt a self-management approach to chronic pain: The Pain Stages of Change Questionnaire (PSOCQ).
        Pain. 1997; 72: 227-234
        • Liao J.J.
        • Lewis J.W.
        A note on concordance correlation coefficient.
        PDA J Pharm Sci Technol. 2000; 54: 23-26
        • Lin L.I.
        A concordance correlation coefficient to evaluate reproducibility.
        Biometrics. 1989; 45: 255-268
        • Logan D.E.
        • Conroy C.
        • Sieberg C.B.
        • Simons L.E.
        Changes in willingness to self-manage pain among children and adolescents and their parents enrolled in an intensive interdisciplinary pediatric pain treatment program.
        Pain. 2012; 153: 1863-1870
        • Miro J.
        • Huguet A.
        • Nieto R.
        Predictive factors of chronic pediatric pain and disability: A Delphi poll.
        J Pain. 2007; 8: 774-792
        • Monticone M.
        • Ferrante S.
        • Ferrari S.
        • Mugnai R.
        • Pillastrini P.
        • Rocca B.
        • Vanti C.
        • Foti C.
        Development of the Italian version of the Pain Stages of Change Questionnaire in patients with chronic low back pain: Cross-cultural adaptation, confirmatory factor analysis, reliability and validity.
        Int J Rehabil Res. 2014; 37: 205-211
        • Muthén L.K.
        • Muthén B.O.
        Mplus User's Guide.
        7th ed. Muthén & Muthén, Los Angeles, CA1998-2012
        • Palermo T.M.
        • Lewandowski A.S.
        • Long A.C.
        • Burant C.J.
        Validation of a self-report questionnaire version of the Child Activity Limitations Interview (CALI): The CALI-21.
        Pain. 2008; 139: 644-652
        • Palermo T.M.
        • Witherspoon D.
        • Valenzuela D.
        • Drotar D.D.
        Development and validation of the Child Activity Limitations Interview: A measure of pain-related functional impairment in school-age children and adolescents.
        Pain. 2004; 109: 461-470
        • Palermo T.M.
        • Law E.F.
        • Essner B.
        • Jessen-Fiddick T.
        • Eccleston C.
        Adaptation of Problem-Solving Skills Training (PSST) for parent caregivers of youth with chronic pain.
        Clin Pract Pediatr Psychol. 2014; 2: 212-223
        • Prochaska J.O.
        • Velicer W.F.
        The transtheoretical model of health behavior change.
        Am J Health Promot. 1997; 12: 38-48
        • Simons L.E.
        • Sieberg C.B.
        • Claar R.L.
        Anxiety and impairment in a large sample of children and adolescents with chronic pain.
        Pain Res Manag. 2012; 17: 93-97
        • Simons L.E.
        • Sieberg C.B.
        • Pielech M.
        • Conroy C.
        • Logan D.E.
        What does it take? Comparing intensive rehabilitation to outpatient treatment for children with significant pain-related disability.
        J Pediatr Psychol. 2013; 38: 213-223
        • Strong J.
        • Westbury K.
        • Smith G.
        • McKenzie I.
        • Ryan W.
        Treatment outcome in individuals with chronic pain: Is the Pain Stages of Change Questionnaire (PSOCQ) a useful tool?.
        Pain. 2002; 97: 65-73
        • Strube M.J.
        Reliability and generalizability theory.
        in: Grimm L.G. Yarnold P.R. Reading and Understanding More Multivariate Statistics. American Psychological Association, Washington, DC2000: 23-31
        • Sullivan M.J.
        • Thorn B.
        • Haythornthwaite J.A.
        • Keefe F.
        • Martin M.
        • Bradley L.A.
        • Lefebvre J.C.
        Theoretical perspectives on the relation between catastrophizing and pain.
        Clin J Pain. 2001; 17: 52-64