Validation of a Chinese version of the Chronic Pain Acceptance Questionnaire (CAPQ) and CPAQ-8 in chronic pain patients

Yaqun Liu, Lei Wang, Yibo Wei, Xiaolin Wang, Tianming Xu, Jinhai Sun, Yaqun Liu, Lei Wang, Yibo Wei, Xiaolin Wang, Tianming Xu, Jinhai Sun

Abstract

Acceptance of chronic pain has increasingly become a significant issue in the field of pain management. Many researchers have suggested that patients with better acceptance of pain are more likely to have better functioning both in physical and psychological status. In many countries, the Chronic Pain Acceptance Questionnaire (CPAQ) and CPAQ-8 have been validated and utilized frequently to measure the pain acceptance of patients with chronic pain. However, the CPAQ and CPAQ-8 yet have not been introduced and validated in Mainland China.In this study, we aimed to translate the English version of the CPAQ into simplified Chinese, make proper cross-cultural adaptations, and validate the psychometric properties of the Chinese version of the CPAQ and the CPAQ-8.The English version of the CPAQ was first linguistically translated and cross-culturally adapted to formulate a Chinese version. Then, we recruited 224 patients from a pain clinic and every participant was asked to finish a series of questionnaires. Finally, statistical analysis was performed to test the psychometric properties of the CPAQ and the CPAQ-8.Both confirmatory factor analysis (CFA) and principal component analysis (PCA) confirmed a 2-factor structure for the CPAQ and the CPAQ-8. Nine out of 10 of the hypotheses were validated for construct validity. The overall intraclass correlation coefficient (ICC) value for the CPAQ and CPAQ-8 were 0.92 and 0.89, respectively. In addition, the Cronbach α values for both the CPAQ and the CPAQ-8 showed excellent test-retest reliability.In conclusion, the original CPAQ was successfully developed into the Chinese version of the CPAQ and CPAQ-8 with excellent validity and reliability. The scores of the CPAQ or CPAQ-8 might be a strong predictor for the physical and psychological function of chronic pain patients. In addition, to improve the satisfaction of surgery patients, we recommend measuring patients' pain acceptance using the CPAQ or CPAQ-8 before and after the surgery. For patients with lower acceptance, psychological interventions may be more effective than treatment that simply reduces symptoms. Finally, we suggest that the Chinese version of the CPAQ and CPAQ-8 are appropriate for use in clinical settings or fundamental research in Mainland China.

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Scree plot indicating an optimal 2-factor solution for the Chinese version of the CPAQ. CPAQ = Chronic Pain Acceptance Questionnaire.
Figure 2
Figure 2
Scree plot indicating an optimal 2-factor solution for the Chinese version of the CPAQ-8. CPAQ = Chronic Pain Acceptance Questionnaire.
Figure 3
Figure 3
Two-factor structure of the Chinese version of the CPAQ (n = 224) with standardized parameter estimates. Numbers are mean standardized path coefficients. CPAQ = Chronic Pain Acceptance Questionnaire, AE = Activity Engagement, PW = Pain Willingness.
Figure 4
Figure 4
Two-factor structure of the Chinese version of the CPAQ-8 (n = 224) with standardized parameter estimates. Numbers are mean standardized path coefficients. CPAQ = Chronic Pain Acceptance Questionnaire, AE = Activity Engagement, PW = Pain Willingness.

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