Sook Hui Chaw1, Yoke Lin Lo2, Jia Yin Lee3, Jia Wing Wong3, Wan Aizat Wan Zakaria1, Shairil Rahayu Ruslan1, Wei Keang Tan1, Ina Ismiarti Shariffuddin1. 1. Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 2. Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia. Yokelinlo@imu.edu.my. 3. Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia.
Abstract
BACKGROUND: The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain management with better patient satisfaction. Previous studies revealed that subscales of "patients' perception of pain management" were unstable cross-culturally. This study aims to evaluate the construct validity of the APS-POQ-R in gynecological postoperative patients with a multi-cultural background using confirmatory factor analysis to allow comparisons among different a priori models at the latent factor level. METHODS: Patients aged 18 years old or above and who were scheduled for gynecology surgery were selected. Three different models with a combination of latent factors were based on a priori hypotheses from previous studies. The root-mean-squared error of approximation, comparative fit index, Tucker-Lewis Index, Chi-squared test, and change in Chi-squared statistic given a change in degrees of freedom between models were used to assess the model fit to the present data. RESULTS: A total of 302 patients completed the questionnaire. The five-factor model which was based on Gordon's study has an acceptable fit for the data and was superior when compared to the one-factor baseline model. Although the four-factor model, which originated from Botti's study, also demonstrates a good model fit, the "perception of care" construct was excluded in this model. The "perception of care" construct is conceptually important as patient-centered care has become the focus of quality improvement of pain service. CONCLUSIONS: The APS-POQ-R is easy to administer and is useful for quality evaluation in postoperative pain management. The present study demonstrates that a five-factor structure of the APS-POQ-R is the best fitting model in our patient sample. The results of this study provide further evidence to support the use of APS-POQ-R as a measurement tool for pain management evaluation in acute postoperative patients with a multi-cultural background.
BACKGROUND: The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain management with better patient satisfaction. Previous studies revealed that subscales of "patients' perception of pain management" were unstable cross-culturally. This study aims to evaluate the construct validity of the APS-POQ-R in gynecological postoperative patients with a multi-cultural background using confirmatory factor analysis to allow comparisons among different a priori models at the latent factor level. METHODS: Patients aged 18 years old or above and who were scheduled for gynecology surgery were selected. Three different models with a combination of latent factors were based on a priori hypotheses from previous studies. The root-mean-squared error of approximation, comparative fit index, Tucker-Lewis Index, Chi-squared test, and change in Chi-squared statistic given a change in degrees of freedom between models were used to assess the model fit to the present data. RESULTS: A total of 302 patients completed the questionnaire. The five-factor model which was based on Gordon's study has an acceptable fit for the data and was superior when compared to the one-factor baseline model. Although the four-factor model, which originated from Botti's study, also demonstrates a good model fit, the "perception of care" construct was excluded in this model. The "perception of care" construct is conceptually important as patient-centered care has become the focus of quality improvement of pain service. CONCLUSIONS: The APS-POQ-R is easy to administer and is useful for quality evaluation in postoperative pain management. The present study demonstrates that a five-factor structure of the APS-POQ-R is the best fitting model in our patient sample. The results of this study provide further evidence to support the use of APS-POQ-R as a measurement tool for pain management evaluation in acute postoperative patients with a multi-cultural background.
Authors: Debra B Gordon; June L Dahl; Christine Miaskowski; Bill McCarberg; Knox H Todd; Judith A Paice; Arthur G Lipman; Marilyn Bookbinder; Steve H Sanders; Dennis C Turk; Daniel B Carr Journal: Arch Intern Med Date: 2005-07-25
Authors: Debra B Gordon; Rosemary C Polomano; Teresa A Pellino; Dennis C Turk; Lance M McCracken; Gwen Sherwood; Judith A Paice; Mark S Wallace; Scott A Strassels; John T Farrar Journal: J Pain Date: 2010-04-18 Impact factor: 5.820