Development and Validation of Short Forms of the Pain Catastrophizing Scale (F-PCS-5) and Tampa Scale for Kinesiophobia (F-TSK-6) in Musculoskeletal Chronic Pain Patients

Abstract

Purpose

Chronic pain is a complex phenomenon. Understanding its multiple dimensions requires the use of a combination of several patient-reported outcome measures (PROMs). However, completing multiple PROMs is time-consuming and can be a burden for patients. The objective of our study was to simultaneously reduce the French versions of the Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) questionnaires to enable their use in an ambulatory and clinical settings.

Patients and Methods

We conducted a clinical study between May 2014 and August 2020 in our rehabilitation center. 1428 chronic musculoskeletal pain patients (CMSP) were included. The originality of our approach is that the reduction method included qualitative as well as quantitative analyses. The study was divided into two parts: 1) reduction of the questionnaires (n=1363) based on internal consistency (item-to-total correlation), principal component analysis (item loadings), Rasch analysis (infit/outfit), floor and ceiling effect (quantitative analyses) and expert judgment of items (qualitative analysis), and 2) validation of the reduced questionnaires (n=65), including test–retest reliability (intraclass correlation coefficient [ICC]), homogeneity (Cronbach α), criterion validity (Pearson correlation [r] with the long-version score), determination of the pathological cutoff and Minimal Clinically Important Difference (MCID). The two full-length questionnaires include 30 items in total.

Results

The reduction resulted in a 5-item PCS (score 0–20) and 6-item TSK (score 0–24). Psychometric properties of the reduced questionnaires were all acceptable as compared with other version (α=0.89 and 0.71, ICC=0.75 and 0.60, r=0.86 and 0.70, MCID=2 and 2 for PCS and TSK, respectively) while keeping the structure and coherence of the long versions.

Conclusion

The two reduced versions of the PCS and TSK can be used in CMSP patient. As their administration only requires a few minutes, they can be implemented in outpatient consultation as well as in clinical settings.

Keywords:

• chronic musculoskeletal pain
• CMSP
• patient-reported outcomes measures
• PROMs
• Pain Catastrophizing Scale
• PCS
• Tampa Scale for Kinesiophobia
• TSK

Abbreviations

CMSP, Chronic Musculoskeletal Pain; PROMs, Patient-Reported Outcome Measures; PCS, Pain Catastrophizing Scale; TSK, Tampa Scale for Kinesiophobia; MCID, Minimal Clinically Important Difference; ICC, Intraclass Correlation Coefficient; SEM, Standard Error of Measurement; IQR, Interquartile Range; PCA, Principal Component Analysis.

Data Sharing Statement

The datasets used during the current study are available from the corresponding author on reasonable request.

Acknowledgments

We gratefully thank the expert team (Favre Christine, Bender Bénédicte, Foli Marlène, Nesa Thomas, Gasser Léo) of the Clinique romande de réadaptation, Sion, Switzerland, who participated in selecting the items, as well as the nursing team who distributed the questionnaires.

Disclosure

The authors report no conflicts of interest related to this work.