TY - JOUR
T1 - The dimensionality of pain
T2 - Palliative care and chronic pain patients differ in their reports of pain intensity and pain interference
AU - Fayers, Peter M.
AU - Hjermstad, Marianne J.
AU - Klepstad, Pål
AU - Loge, Jon Håvard
AU - Caraceni, Augusto
AU - Hanks, Geoffrey W.
AU - Borchgrevink, Petter
AU - Kaasa, Stein
N1 - Acknowledgement
The European Palliative Care Research Collaborative is funded by the European Commission’s Sixth Framework Programme (Contract No LSHC-CT-2006-037777) with the overall aim to improve treatment of pain, depression, and fatigue through translation research. Core scientific group/work package leaders: Stein Kaasa (project coordinator), Frank Skorpen, Marianne Jensen Hjermstad, and Jon Håvard Loge, Norwegian University of Science and Technology (NTNU); Geoffrey Hanks, University of Bristol; Augusto Caraceni and Franco De Conno, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; Irene Higginson, King’s College London; Florian Strasser, Cantonal Hospital St. Gallen; Lukas Radbruch, RWTH Aachen University; Kenneth Fearon, University of Edinburgh; Hellmut Samonigg, Medical University of Graz; Ketil Bø, Trollhetta AS, Norway; Irene Rech-Weichselbraun, Bender MedSystems GmbH, Austria; Odd Erik Gundersen, Verdande Technology AS, Norway. Scientific advisory group: Neil Aaronson, The Netherlands Cancer Institute; Vickie Baracos and Robin Fainsinger, University of Alberta; Patrick C. Stone, St. George’s University of
London; Mari Lloyd-Williams, University of Liverpool. Project management:
Stein Kaasa, Ola Dale, and Dagny F. Haugen, NTNU.
PY - 2011/7/1
Y1 - 2011/7/1
N2 - The accurate, precise, and consistent assessment of pain is of particular importance in palliative care. The European Palliative Care Research Collaborative is developing a computer-based pain assessment instrument and has been evaluating the content and dimensionality of existing pain questionnaires. The most important dimensions of pain are intensity and interference. However, since pain interference is a consequence of and largely reflects pain intensity, we postulated that it might either provide information to enhance the evaluation of intensity, or that an overall summary measure of pain severity could be constructed by combining the 2 dimensions. Cancer patients in palliative care (n = 395) and chronic pain patients (n = 168) completed questionnaires that included 23 pain items culled from existing questionnaires. Psychometric analyses confirmed the existence of 2 main dimensions, intensity and interference, and also guided identification of items that contributed most strongly to these dimensions. However, there was strong evidence that the relationship between the intensity and the interference items differs markedly in palliative care patients compared to chronic pain patients. As hypothesized, there was strong correlation between intensity and interference, lending support to the possibility that, for some purposes, these dimensions may be combined to provide a higher-level summary measure of patients' pain experience. We conclude that these dimensions should be kept distinct when assessing patients in general, although for a single type of patient (such as palliative care patients), it may be possible to regard intensity and interference as contributing to an overall measure of pain severity. Pain intensity and interference are highly correlated but represent clinically distinct and important dimensions. For clinical trials, a single "severity" summary score is proposed.
AB - The accurate, precise, and consistent assessment of pain is of particular importance in palliative care. The European Palliative Care Research Collaborative is developing a computer-based pain assessment instrument and has been evaluating the content and dimensionality of existing pain questionnaires. The most important dimensions of pain are intensity and interference. However, since pain interference is a consequence of and largely reflects pain intensity, we postulated that it might either provide information to enhance the evaluation of intensity, or that an overall summary measure of pain severity could be constructed by combining the 2 dimensions. Cancer patients in palliative care (n = 395) and chronic pain patients (n = 168) completed questionnaires that included 23 pain items culled from existing questionnaires. Psychometric analyses confirmed the existence of 2 main dimensions, intensity and interference, and also guided identification of items that contributed most strongly to these dimensions. However, there was strong evidence that the relationship between the intensity and the interference items differs markedly in palliative care patients compared to chronic pain patients. As hypothesized, there was strong correlation between intensity and interference, lending support to the possibility that, for some purposes, these dimensions may be combined to provide a higher-level summary measure of patients' pain experience. We conclude that these dimensions should be kept distinct when assessing patients in general, although for a single type of patient (such as palliative care patients), it may be possible to regard intensity and interference as contributing to an overall measure of pain severity. Pain intensity and interference are highly correlated but represent clinically distinct and important dimensions. For clinical trials, a single "severity" summary score is proposed.
KW - Pain dimensionality
KW - Pain intensity
KW - Pain interference
KW - Pain severity
UR - http://www.scopus.com/inward/record.url?scp=79957650482&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2011.02.052
DO - 10.1016/j.pain.2011.02.052
M3 - Article
C2 - 21458921
AN - SCOPUS:79957650482
VL - 152
SP - 1608
EP - 1620
JO - Pain
JF - Pain
SN - 0304-3959
IS - 7
ER -
