Chronic pain management a fundamental human right: adaptation and examination of psychometric properties of pain anxiety symptoms scale among osteoporosis sample from Pakistan

Abstract

PurposeChronic pain is a global community health and human rights issue. Proper health care is an important necessity for every human being and access for treatment is every human’s right. Likewise, it is significant that proper instruments should be administered to assess these clinical issues. It is equally necessary to reassess these tools accordingly to diverse cultures, especially subjective tools to check their validity and cultural specification. The purpose of this study is to adapt and examine the factorial structure of 20 items and three-factor structure, pain anxiety symptoms scale (McCracken and Dhingra, 2002). As literature evidence suggested of a three-factor structure (Cho, 2010).Design/methodology/approachPrimarily, the scale was translated into Urdu language using the forward-backward method. Afterward, a reliability assessment and a confirmatory factor analysis (CFA) for construct validity, on an osteoporosis patients’ sample (N = 250) was performed. Subsequently, an Obliman method exploratory factor analysis (EFA) was conducted on an osteoporosis sample (N = 500) for factor structuring followed by validity and reliability analysis.FindingsThe initial findings demonstrated a high internal consistency of the translated version of the scale (α = 0.85) and an acceptable test-retest reliability (r = 0.69). CFA displayed a high inter-correlation between scale and its subscales. However, CFA suggested a three-factor model. Consequently, EFA proposed a three-factor, 19 item scale, namely, behavioral; cognitive; and physical subscale, which demonstrated high alpha reliability (α.= 0.86). Other results indicated the scale to have a significant predictive and convergent validity for depression and positive and negative affect.Originality/valueThe present study is novel in its approach as the present study not only tried to adapt the original Pain Anxiety Symptom Scale to Pakistani culture but has also checked the factorial structure of the original scale. The results achieved in the process suggested a three-factor structure scale with 19 items in opposition to the original four structured, 20 items scale.