Cross-cultural adaptation of the German Pain Solutions Questionnaire: an instrument to measure assimilative and accommodative coping in response to chronic pain

Robert Sielski, Julia Anna Glombiewski, Winfried Rief, Geert Crombez, Antonia Barke, Robert Sielski, Julia Anna Glombiewski, Winfried Rief, Geert Crombez, Antonia Barke

Abstract

According to the dual process model of coping, assimilative or accommodative strategies can be applied to deal with aversive life situations. In people with chronic pain, the tenacious focus on achieving analgesia is often referred to as assimilative coping and associated with more disability and catastrophic thinking. In contrast, accommodative coping (accepting one's pain and setting new goals) appears to have beneficial effects. To assess how people with chronic pain use these different coping strategies, questionnaires measuring these concepts are needed. Following international guidelines, a German version of the Pain Solutions Questionnaire (PaSol) was prepared. A sample of 165 participants with chronic low back pain (CLBP; 60% women; age 53 ± 8.4 years) filled in the questionnaire and measures for pain-related disability, affective distress, catastrophic thinking, and attention to pain. Item analyses, an exploratory factor analysis, and correlations with pain-related measures were calculated. In addition, data from 98 participants who received psychological treatment were examined to investigate the PaSol's sensitivity to change. The exploratory factor analysis reproduced the original questionnaire's four-factor structure. Internal consistencies for the subscales ranged from Cronbach's α=0.72 to α =0.84. Mean item difficulties for the subscales ranged from pi=0.62 to pi=0.79. The highest correlations were found for Meaningfulness with catastrophic thinking (r=-0.58) and affective distress (r=-0.36). The PaSol subscale Meaningfulness predicted pain-related disability; the subscales Meaningfulness and Solving Pain predicted affective distress. Furthermore, the PaSol was found to be sensitive to detect changes over time. The German version of the PaSol is a reliable and valid instrument in the measurement of assimilative and accommodative coping strategies in people suffering from CLBP. It may provide a useful tool when examining temporal dynamics of the changing coping strategies in the transition from acute to chronic pain as well as during pain treatments.

Keywords: German; acceptance; back pain; coping; problem-solving; validation.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Mean scores and standard deviations of the PaSol subscales before and after a psychological intervention for patients who showed an improvement of at least 30% in the Pain Disability Index (improved) or failed to do so (not improved). Notes: If a 2×2 ANOVA indicated an interaction effect, the results of the post hoc tests are shown. **p<0.01; ***p<0.001. (A) Mean scores and standards deviations of the PaSol subscale Meaningfulness of Life Despite Pain. (B) Mean scores and standards deviations of the PaSol subscale Pain Solving. (C) Mean scores and standards deviations of the PaSol subscale Acceptance of the Insolubility of the Pain. (D) Mean scores and standards deviations of the PaSol subscale Belief in a Solution. Abbreviation: PaSol, Pain Solutions Questionnaire.

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