The Clinical Utility of a Brief Psychological Stress Measure (Patient-Reported Outcomes Measurement Information System) in Youth with Chronic Pain

Abstract

Objective: To preliminarily examine the psychometric properties (i.e., internal consistency reliability, construct validity) and clinical utility of the Patient-Reported Outcomes Measurement Information System (PROMIS) psychological stress experiences scale in a sample of youth with chronic pain.

Methods: Participant data were gathered from an institutional review board (IRB) approved clinical data registry. One hundred sixty-eight children and adolescents (age: mean = 14.97, SD = 2.78) with chronic pain presenting to a tertiary pain treatment clinic were included in the data set. Internal consistency estimates (i.e., Cronbach's alpha), bivariate correlations, and confirmatory factor analyses were performed to preliminarily examine reliability and validity. Multivariate regression analyses were performed to examine the associations between PROMIS psychological stress and pain-related and psychosocial outcomes.

Results: Confirmatory factor analysis and correlational results indicated that the PROMIS psychological stress experiences scale shows promising reliability and validity in the current sample of youth with chronic pain. Additionally, the results indicated that almost 50% of youth with chronic pain report "high" or "very high" stress (T ≥ 60) and significantly higher rates of stress when compared with national validation samples (P < 0.001). The results also indicated that the PROMIS psychological stress experiences scale was significantly associated with both pain-related and psychosocial outcomes (all P <0.01).

Conclusions: The PROMIS psychological stress experiences scale shows promising psychometric properties in youth with pediatric pain and may be useful in assessing for psychological impairment. Future research should further examine the use of this brief measure to assess psychological stress in medical clinics as a way to enhance intervention and prevention efforts in these youth.

Keywords: Chronic Pain; Measurement; Psychosocial Factors; Stress.