Development of the Chronic Pain Cognition Scale: A Culture-Sensitive Pain Measurement in Chinese

Chih-Hsun Wu; Wei-Han Chou; Yi-Hsun Long; Hao-Han Yang; Tung Lin; Chi-Cheng Yang; Wei-Zen Sun; Chih-Cheng Chen; Chih-Peng Lin

doi:10.2147/JPR.S422197

Development of the Chronic Pain Cognition Scale: A Culture-Sensitive Pain Measurement in Chinese

J Pain Res. 2023 Sep 6:16:3075-3084. doi: 10.2147/JPR.S422197. eCollection 2023.

Authors

Chih-Hsun Wu^{1

2}, Wei-Han Chou³, Yi-Hsun Long², Hao-Han Yang¹, Tung Lin¹, Chi-Cheng Yang^{1

4}, Wei-Zen Sun³, Chih-Cheng Chen⁵, Chih-Peng Lin³

Affiliations

¹ Department of Psychology, National Chengchi University, Taipei, Taiwan.
² Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Holistic Mental Health Center, Taipei City Hospital, Taipei, Taiwan.
⁵ Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.

Abstract

Purpose: People with pain problems are highly vulnerable to cultural disparities, and it is imperative to reduce these inequalities. This cross-sectional study aimed to develop a culturally sensitive Chronic Pain Cognition Scale (CPCS) for Chinese-/Chinese dialect-speaking populations and investigate its psychometric properties.

Patients and methods: Adult patients with chronic low back pain or chronic neck pain who visited pain clinics at a medical center in northern Taiwan were enrolled. Participants completed the demographic, intensity of pain, and two other related sensations, "Sng ()" and "Ma ()", often reported in Chinese-speaking populations, CPCS, Chronic Pain Acceptance Questionnaire-8, and Pain Self-Efficacy Questionnaire.

Results: 200 patients were included. Patients' mean age was 64.84 ± 14.33, 126 (63.0%) were female, and 83 (41.5%) had 13+ years of education. The average duration of pain was 77.25 ± 97.46 months, the intensity of pain was 6.04 ± 2.50, Ma was 3.43 ± 3.24, and Sng was 4.54 ± 3.14. The CPCS comprised four factors: pain impact (how pain impact one's life), losing face (how one being disrespected due to pain), helplessness, and avoidance, with good structural validity and adequate reliability (Cronbach α, 0.60-0.81) and satisfactory criterion-related validity. Moreover, losing face, an essential concept in Chinese relationalism, was significantly related to pain, Sng, and Ma (r = 0.19, 0.15 and 0.16), but not to pain acceptance or self-efficacy, indicating a culturally specific element in pain measurement.

Conclusion: The CPCS has good psychometric properties and is suitable for evaluating chronic pain in the clinical setting, and might be generalizable to other Chinese-/Chinese dialect-speaking populations.

Keywords: avoidance; helplessness; losing face; low back pain; neck pain; pain impact.

Grants and funding

This work was supported by the Ministry of Science and Technology, Taiwan (Reorganized as National Science and Technology Council, Taiwan in July 2022) [grant number MOST 105-2410-H-004-074, MOST 106-2410-H-004 −070 -SSS, and 110-2410-H-004-113-MY2] to the first author.