Reliability, validity, and simplification of the Chinese version of the Global Pain Scale in patients with rheumatoid arthritis

Haoyang Chen; Xiaoxiao Wang; Ting Bai; Hengmei Cui; Songsong Shi; Yunyun Li; Guang-Yin Xu; Huiling Li; Biyu Shen

doi:10.1186/s12912-023-01664-4

Reliability, validity, and simplification of the Chinese version of the Global Pain Scale in patients with rheumatoid arthritis

BMC Nurs. 2024 Jan 5;23(1):20. doi: 10.1186/s12912-023-01664-4.

Authors

Haoyang Chen^#^{1

2}, Xiaoxiao Wang^#³, Ting Bai^#⁴, Hengmei Cui^{1

2}, Songsong Shi^{1

2}, Yunyun Li^{1

2}, Guang-Yin Xu⁵, Huiling Li⁶, Biyu Shen^{7

8}

Affiliations

¹ Department of Nursing, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong New Area, Shanghai, China.
² Shanghai Jiao Tong University School of Nursing, Shanghai, China.
³ Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
⁴ Department of Nursing, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China.
⁵ Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University, Suzhou, China.
⁶ Department of Nursing, Nursing School of Soochow University, 1 Shizi Street, Wuzhong District, Suzhou, China. lhl8543@126.com.
⁷ Department of Nursing, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong New Area, Shanghai, China. shenbiyu@126.com.
⁸ Shanghai Jiao Tong University School of Nursing, Shanghai, China. shenbiyu@126.com.

^# Contributed equally.

Abstract

Background: Persistent pain is the most reported symptom in patients with rheumatoid arthritis (RA); however, effective and brief assessment tools are lacking. We validated the Chinese version of the Global Pain Scale (C-GPS) in Chinese patients with RA and proposed a short version of the C-GPS (s-C-GPS).

Method: The study was conducted using a face-to-face questionnaire survey with a multicenter cross-sectional design from March to December 2019. Patients aged > 18 years who met the RA diagnostic criteria were included. Based on the classical test theory (CTT) and the item response theory (IRT), we assessed the validity and reliability of the C-GPS and the adaptability of each item. An s-C-GPS was developed using IRT-based computerized adaptive testing (CAT) analytics.

Results: In total, 580 patients with RA (mean age, 51.04 ± 24.65 years; mean BMI, 22.36 ± 4.07 kg/m²), including 513 (88.4%) women, were included. Most participants lived in a suburb (49.3%), were employed (72.2%) and married (91.2%), reported 9-12 years of education (66.9%), and had partial medical insurance (57.8%). Approximately 88.1% smoked and 84.5% drank alcohol. Analysis of the CTT demonstrated that all items in the C-GPS were positively correlated with the total scale score, and the factor loadings of all these items were > 0.870. A significant positive relationship was found between the Visual Analog Scale (VAS) and the C-GPS. IRT analysis showed that discrimination of the C-GPS was between 2.271 and 3.312, and items 6, 8, 13, 14, and 16 provided a large amount of information. Based on the CAT and clinical practice, six items covering four dimensions were included to form the s-C-GPS, all of which had very high discrimination. The s-C-GPS positively correlated with the VAS.

Conclusion: The C-GPS has good reliability and validity and can be used to evaluate pain in RA patients from a Chinese cultural background. The s-C-GPS, which contains six items, has good criterion validity and may be suitable for pain assessment in busy clinical practice.

Trial registration: This cross-sectional study was registered in the Chinese Clinical Trial Registry (ChiCTR1800020343), granted on December 25, 2018.

Keywords: Computerized adaptive testing.; Global Pain Scale; Item response theory; Reliability; Rheumatoid arthritis; Short-version; Validity.

Abstract

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