Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

Mari Botti; Damien Khaw; Emmy Brandt Jørgensen; Bodil Rasmussen; Susan Hunter; Bernice Redley

doi:10.1016/j.jpain.2015.03.016

Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

J Pain. 2015 Aug;16(8):727-40. doi: 10.1016/j.jpain.2015.03.016. Epub 2015 May 19.

Authors

Mari Botti¹, Damien Khaw², Emmy Brandt Jørgensen³, Bodil Rasmussen⁴, Susan Hunter⁴, Bernice Redley¹

Affiliations

¹ Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia.
² Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia. Electronic address: [email protected].
³ Department of Nursing Research, VIA University College, Holstebro, Denmark; Hospitalsenheden Vest, Region Midtjylland, Denmark.
⁴ School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia.

PMID: 25998207
DOI: 10.1016/j.jpain.2015.03.016

Abstract

This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), a measure of the quality of postoperative pain management used internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from 2 point prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients, respectively. Parallel analysis indicated 4- and 3-factor solutions for Danish and Australian patients, respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α = .54) and Australian (Cronbach α = .63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience," but not "pain management." This finding reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference, whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings with past research conducted in the United States and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience" but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally.

Perspective: This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted the difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.

Keywords: Pain experience; construct validity; cross-cultural; patient participation; quality improvement.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Austria
Chi-Square Distribution
Cross-Cultural Comparison*
Denmark
Factor Analysis, Statistical
Female
Health Surveys
Humans
Iceland
Male
Middle Aged
Outcome Assessment, Health Care* / methods
Outcome Assessment, Health Care* / standards
Pain Management*
Pain, Postoperative / epidemiology
Pain, Postoperative / therapy*
Reference Values
Reproducibility of Results
Societies, Medical / standards*
Surveys and Questionnaires*
United States