Development of the Chronic Pain Cognition Scale: A Culture-Sensitive Pain Measurement in Chinese

Abstract

Chih-Hsun Wu,1,2 Wei-Han Chou,3 Yi-Hsun Long,2 Hao-Han Yang,1 Tung Lin,1 Chi-Cheng Yang,1,4 Wei-Zen Sun,3 Chih-Cheng Chen,5 Chih-Peng Lin3 1Department of Psychology, National Chengchi University, Taipei, Taiwan; 2Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan; 3Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan; 4Holistic Mental Health Center, Taipei City Hospital, Taipei, Taiwan; 5Institute of Biomedical Sciences, Academia Sinica, Taipei, TaiwanCorrespondence: Chih-Peng Lin, Department of Anesthesiology, National Taiwan University Hospital, 7 Chung Shan S. Road, Taipei, 100225, Taiwan, Tel [phone] #262158, Fax [phone], Email [email protected]: People with pain problems are highly vulnerable to cultural disparities, and it is imperative to reduce these inequalities. This cross-sectional study aimed to develop a culturally sensitive Chronic Pain Cognition Scale (CPCS) for Chinese-/Chinese dialect-speaking populations and investigate its psychometric properties.Patients and Methods: Adult patients with chronic low back pain or chronic neck pain who visited pain clinics at a medical center in northern Taiwan were enrolled. Participants completed the demographic, intensity of pain, and two other related sensations, “Sng (痠)” and “Ma (麻)”, often reported in Chinese-speaking populations, CPCS, Chronic Pain Acceptance Questionnaire-8, and Pain Self-Efficacy Questionnaire.Results: 200 patients were included. Patients’ mean age was 64.84 ± 14.33, 126 (63.0%) were female, and 83 (41.5%) had 13+ years of education. The average duration of pain was 77.25 ± 97.46 months, the intensity of pain was 6.04 ± 2.50, Ma was 3.43 ± 3.24, and Sng was 4.54 ± 3.14. The CPCS comprised four factors: pain impact (how pain impact one’s life), losing face (how one being disrespected due to pain), helplessness, and avoidance, with good structural validity and adequate reliability (Cronbach α, 0.60– 0.81) and satisfactory criterion-related validity. Moreover, losing face, an essential concept in Chinese relationalism, was significantly related to pain, Sng, and Ma (r = 0.19, 0.15 and 0.16), but not to pain acceptance or self-efficacy, indicating a culturally specific element in pain measurement.Conclusion: The CPCS has good psychometric properties and is suitable for evaluating chronic pain in the clinical setting, and might be generalizable to other Chinese-/Chinese dialect-speaking populations.Keywords: low back pain, neck pain, pain impact, losing face, helplessness, avoidance

Keywords

• low back pain
• neck pain
• pain impact
• losing face
• helplessness
• avoidance