Background & Aims

Pain avoidant behaviour predicts reduced function in children and adolescents (CaA) with persistent pain. A model to explain this causal relationship is the Fear-Avoidance Model of Pain (FAM) [1-3]. In FAM pain-related fear plays an important role in the development and maintenance of avoidant behaviour. Thus, there is a need to improve knowledge about pain-related fear and how to address it in assessment and treatment. The Fear of Pain Questionnaire – Child Report Short Form (FOPQC-SF) is a self-report questionnaire to assess pain-related fear in CaA. Until now it has not been available in the Swedish language [4, 5]. When translating a self-report questionnaire into a new language it is of great importance that it is also adapted to the context and target group where it will be used [6]. Thus, the overall aim of this study was to develop a Swedish version of the FOPQC-SF and to describe a user-oriented translation and adaptation process.

Methods

FOPQC-SF consists of ten items rated on a 5-point Likert scale. Greater scores indicate higher levels of pain-related fear and avoidance. The translation and linguistic adaptation of the FOPQC-SF was performed using the Dual Panel Method in two steps [6, 7]. In step 1, a bilingual panel created a first version of the questionnaire and, in step 2, this first version was presented and revised by a panel of five CaA without persistent pain. The translated and revised Swedish version of the FOPQC-SF was then used for individual cognitive interviews with six CaA with persistent pain [8-10]. During the cognitive interviews, the participants’ understanding of the language and content of the questionnaire was examined. The cognitive interviews also contributed to an increased knowledge of the content and face validity of the questionnaire. After each step of the dual panel method and after cognitive interviewing the questionnaire was revised by the research group.

Results

The bilingual panel found the FOPQC-SF unproblematic to translate and consensus was easily achieved. Some wordings that needed to be specifically addressed by the lay panel were identified. The CaA in the lay panel found the questionnaire to be a relevant one to answer if they were to seek healthcare due to persistent pain, and they did not think it would be difficult to fill in. Some revisions in wording and expressions were made based on the input of the lay panel. During the cognitive interviews the response option “Unsure” was found to be problematic and was interpreted differently. It was therefore decided to change the scale and only let the anchors be explained verbally. Overall, the FOPQC-SF was perceived as relevant by CaA with persistent pain. The questionnaire was considered to be useful for healthcare providers to understand the child, to be able to help in a good way and was also found to be an opportunity for the child to express its feelings related to having pain.

Conclusions

The dual panel method was found to be an easy-to-use method for translation and adaptation of the FOPQC-SF. It could ensure that the theoretical ground and the intention of the questionnaire was maintained. The involvement of CaA provided good insight into how the FOPQC-SF is understood and interpreted and a good basis for adaptation to the target group and thereby strengthened the validity of the questionnaire. The Swedish FOPQC-SF will be a valuable tool to be used in research as well as in clinical practice for CaA with persistent pain.

References

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Presenting Author

Malin Lanzinger

Poster Authors

Malin Lanzinger

MSc

Lund university

Lead Author

Topics

  • Pain in Special Populations: Adolescents