Development and Validation of the Health Literacy Assessment Instrument for Patients with Chronic Pain.

Matheus Pasquali,Siqing Chen,Bingyu Zhao,Jie Fang,Xingwei Zhang,Meijuan Cao

doi:10.1155/2021/9342746

Abstract

A suitable health literacy assessment instrument for patients with chronic pain (HLCP) in China with good instrument's psychometric properties is required. A theoretical framework for the HLCP was developed by adopting the hierarchical model of health literacy proposed by Nutbeam. The reliability and validity of the HLCP were tested in a cross-sectional survey of 237 chronic pain patients from three pain clinics and wards of Grade-3A hospitals in Zhejiang Province, China. The discriminant degree method, correlation analysis method, factor analysis method (exploratory factor analysis), half reliability, and other methods were utilized to screen items for inclusion in the final version of HLCP, and the fitness of the model was subsequently evaluated by confirmatory factor analysis. Cronbach's alpha value and test-retest with two-week intervals were used to test the internal consistency and retest reliability of the HLCP. In the exploratory factor analysis, three domains, functional health literacy (10 items), interactive health literacy (14 items), and critical health literacy (7 items), comprising 31 items in total, were finally loaded; the model was determined to explain 70.9% of the total variance. HLCP's effective assessment of the health literacy level of patients with chronic pain and its acceptable reliability and validity were revealed through the results.

Highlights

Chronic pain was declared a disease by the International Association for the Study of Pain in 2000 [1]
Chronic pain has been defined as persistent or recurrent pain that lasts for three months or more by the International Association for the Study of Pain [3]; the duration of pain in the definition has been shortened to one month by Chinese scholars, after considering the characteristics of patients with chronic pain [4]
Considering the high validity and reliability of the 31-item HLCP, as well as its advantages, such as the relatively low number of questions, its ease of implementation, and its ability to assess health literacy among patients with various kinds of chronic pain, the HLCP appears to be an appropriate instrument for assessing the health literacy of patients with chronic pain in China and has wide application value

Summary

Introduction

Chronic pain was declared a disease by the International Association for the Study of Pain in 2000 [1]. Chronic pain has been defined as persistent or recurrent pain that lasts for three months or more by the International Association for the Study of Pain [3]; the duration of pain in the definition has been shortened to one month by Chinese scholars, after considering the characteristics of patients with chronic pain [4]. Chronic pain can occur at any age and is persistent and recurrent; it has a high incidence, affecting a large population, and a wide range of influence [5]. Due to its complex etiology and difficulty in the diagnosis of chronic pain and as it does not directly endanger the patient’s life, it can be ignored by researchers [6]. For individuals with chronic pain, failure to obtain a timely diagnosis and reasonable treatment can lead to serious complications, which can cause further and possibly more intense pain and lead to a heavy medical and economic burden to patients’ families and society [9, 10]

Methods

Results

Discussion

Conclusion