The Pain and Sleep Questionnaire three-item index (PSQ-3): A reliable and valid measure of the impact of pain on sleep in chronic nonmalignant pain of various etiologies
The Pain and Sleep Questionnaire three-item index (PSQ-3): A reliable and valid measure of the impact of pain on sleep in chronic nonmalignant pain of various etiologies
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DOI：
10.1155/2012/635967
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发表时间：
2012-07-01
影响因子：
2.9
通讯作者：
Michalko, Kenneth J.
中科院分区：
文献类型：
--
作者：
Ayearst, Lindsay E.;Harsanyi, Zoltan;Michalko, Kenneth J.
背景：睡眠障碍是慢性疼痛患者最常见的主诉之一。由于疼痛相关的睡眠障碍可以作为评估慢性疼痛治疗反应的标志，因此在临床试验方案中纳入一项旨在评估疼痛对睡眠影响的措施是很重要的，如果没有必要的话。通常用于此目的的测量缺乏专门设计用于评估疼痛对睡眠影响的量表，或者基于单个项目。单项目量表缺乏信度，因此缺乏效度。目的：研究嵌入在八项量表中的五项疼痛与睡眠问卷（PSQ）指数的心理测量特性，采用一种公认的方法，在对照临床试验中对慢性非恶性疼痛患者进行回顾性分析。方法：数据来自9个独立、单点、双盲、随机安慰剂对照临床试验，这些试验进行了大约10年的时间，其中大多数是交叉设计。采用交叉验证方法，进行探索性和验证性因素分析，以评估该措施的潜在结构和维度。内部一致性信度采用Cronbach’s alpha系数进行评价。使用平均得分差来评估该指数检测重要治疗变化的能力。计算指数得分与其他健康相关结果测量得分之间的相关系数，以评估该指数的标准效度。最后，采用多元回归分析评估预测效度。结果：合并数据共纳入605例患者（65.5%为女性，平均年龄55.7岁）。研究结果建议修订PSQ指数（PSQ-3）。PSQ-3在样本之间表现出高度的内部一致性（范围从0.82到0.93），并且对检测不同慢性疼痛类别中有意义的治疗效果敏感。PSQ-3与其他健康相关结果测量之间的中至强相关性（r>0.40）为标准相关效度提供了初步证据。多元回归分析的结果表明，PSQ-3在其他健康相关结果测量的得分差异中占29%至40%。结论：结果支持修订后的三项指标评分，用于评估疼痛对睡眠的影响。修订后的指数显示出可接受的内部一致性水平，并初步支持该指数的结构、标准相关和预测效度。
BACKGROUND: Sleep disturbance is among the more common complaints reported by chronic pain patients. Because pain-related sleep disturbance may serve as a marker for the assessment of responses to treatment for chronic pain, inclusion of a measure designed to assess the impact of pain on sleep in clinical trial protocols is important, if not necessary. Measures typically used for this purpose lack scales specifically designed for the assessment of the impact of pain on sleep or are based on a single item. Single-item scales lack reliability and, therefore, validity.OBJECTIVES: To investigate the psychometric properties of the five-item Pain and Sleep Questionnaire (PSQ) Index, which is embedded in the eight-item inventory, by applying an accepted methodology using retrospective analyses in controlled clinical trials in which the measure had been administered among patients with chronic nonmalignant pain.METHODS: Data were pooled from nine independent, single-site, double-blind, randomized placebo-controlled clinical trials conducted over a period of approximately 10 years, the majority of which were cross-over designs. A cross-validation approach was adopted with exploratory and confirmatory factor analyses conducted to evaluate the underlying structure and dimensionality of the measure. Internal consistency reliability was evaluated using Cronbach's alpha coefficient. Mean score differences were used to assess the ability of the index to detect important treatment changes. Correlation coefficients were calculated between index scores and scores from other health-related outcome measures to evaluate the criterion validity of the index. Finally, predictive validity was assessed using multiple regression analyses.RESULTS: Pooling the data resulted in a sample of 605 patients (65.5% female; mean age 55.7 years). Findings suggested a revised three-item PSQ Index (PSQ-3). The PSQ-3 demonstrated high internal consistency across samples ( ranging from 0.82 to 0.93) and was sensitive to detecting meaningful treatment effects within different chronic pain categories. Moderate to strong correlations (r>0.40) between the PSQ-3 and other health-related outcome measures provided preliminary evidence for criterion-related validity. Results of multiple regression analyses demonstrated that the PSQ-3 accounted for between 29% and 40% of the variance in scores from other health-related outcome measures.CONCLUSIONS: Results support the scoring of a revised three-item index for the assessment of the impact of pain on sleep. The revised index demonstrated acceptable levels of internal consistency and preliminary support for the structural, criterion-related and predictive validity of the index was achieved.