Pain coping strategies among patients with haemophilia

Abstract

Pain caused by bleeding episodes is an important aspect of haemophilia, but patients' pain coping strategies have not been widely studied and there is no specific instrument for assessing pain coping among patients with haemophilia. This paper reports an adaptation of the pain coping strategies questionnaire (CSQ) for haemophilia. A sample of patients with severe haemophilia completed the haemophilia-adapted CSQ as well as the beliefs about pain control questionnaire (BPCQ), and provided information about pain frequency and severity, use of analgesics and other drugs, and demographic and other details. The adapted CSQ comprised seven sub-scales from the original CSQ, four sub-scales from a version adapted for sickle cell disorder, and three new sub-scales dealing with specific pain coping behaviours relevant to haemophilia. Internal consistency of the sub-scales ranged from moderate to high, and for existing sub-scales was similar to reports of other patient groups. Principal components analysis indicated two major factors called 'negative thoughts about pain' and 'coping attempts', plus a smaller third factor called 'passive adherence'. Negative thoughts about pain were associated with beliefs about pain being controlled by chance happenings, whereas passive adherence was associated with more frequent visits to health care professionals, greater use of analgesics, and beliefs about pain being controlled by doctors. The findings provide preliminary evidence for the psychometric properties of the adapted questionnaire, which could be used in further research to investigate the role of pain coping in adjustment, disability and quality of life among patients with haemophilia.