Readiness to change in pediatric chronic pain: Initial validation of adolescent and parent versions of the Pain Stages of Change Questionnaire

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Pain (Impact Factor: 5.21). 07/2011; 152(10):2301-11. DOI: 10.1016/j.pain.2011.06.019
Source: PubMed


Despite the clinical importance of readiness to change in predicting treatment outcomes among adults, no studies have examined this construct among pediatric pain patients. Because parents play a key role in adolescent pain management, both adolescent and parent readiness to adopt a self-management approach to pain merit further study. The primary goal of the current study was to validate adolescent and parent-report adaptations of the adult Pain Stages of Change Questionnaire (PSOCQ). Participants included 259 adolescent patients with chronic pain syndromes and their parents presenting to 2 pediatric pain management clinics. Using confirmatory factor analytic techniques, a 4-factor solution was supported for the parent version (PSOCQ-P) that included Precontemplation, Contemplation, Action, and Maintenance factors, whereas the adolescent version (PSOCQ-A) version supported a three-factor model that combines the Action and Maintenance scales. Within both versions, each of the factors was found to be internally consistent. The PSOCQ-A and PSOCQ-P showed evidence of criterion validity through significant correlations with coping strategies and pain catastrophizing. Stability findings at 4 and 8 weeks after a multidisciplinary pain clinic evaluation are reported. Associations between pediatric PSOCQ scores and demographic, pain, and functional domains were explored to inform future research. Further validation of the PSOCQ-A and PSOCQ-P measures with new, separate samples of pediatric pain patients and parents are needed before use in clinical contexts.

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    • " the PPRC group included increased child action / maintenance and parent action scores on the pain readiness to change measure . Based on the transtheoretical model of behavior change ( Prochaska & Velicer , 1997 ) and the stages of change conceptualized for adult ( Kerns , Rosenberg , Jamison , Caudill , & Haythornthwaite , 1997 ) and pediatric ( Guite et al . , 2011 ) chronic pain patients , Action reflects an active involvement in learning self - management strategies and Maintenance reflects a sense of established personal responsibility for pain control . The specific improvements observed for the PPRC likely reflect the therapeutic emphasis of learning self - management strategies and pain mana"
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    • "Furthermore, the Contemplation subscale of the measure has been found to be difficult to interpret in the context of intensive pain rehabilitation treatment [10] [11]. The validation of the youth version of the PSOCQ found that a single subscale combining action and maintenance was more stable and reliable than separate subscales [6]. For ease of comparison, we created a parallel composite Action/Maintenance score for the parent PSOCQ, following the strategy of Jensen et al. [11] of averaging the scores on the 2 separate subscales into a single score. "
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