1. Assessing the Psychometric Properties of an Activity Pacing Questionnaire for Chronic Pain and Fatigue.
- Author
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Antcliff, Deborah, Campbell, Malcolm, Woby, Steve, and Keeley, Philip
- Subjects
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TREATMENT of backaches , *CHRONIC fatigue syndrome treatment , *CHRONIC pain treatment , *PSYCHOLOGICAL adaptation , *BEHAVIOR modification , *CHI-squared test , *STATISTICAL correlation , *DELPHI method , *ENERGY metabolism , *TEST validity , *EXPERIMENTAL design , *FACTOR analysis , *FATIGUE (Physiology) , *RESEARCH methodology , *PROBABILITY theory , *PSYCHOLOGICAL tests , *PSYCHOMETRICS , *QUESTIONNAIRES , *RESEARCH funding , *SCALE analysis (Psychology) , *HEALTH self-care , *STATISTICS , *STATISTICAL reliability , *EFFECT sizes (Statistics) , *PAIN measurement , *INTER-observer reliability , *CROSS-sectional method , *RESEARCH methodology evaluation , *DATA analysis software , *MANN Whitney U Test ,RESEARCH evaluation - Abstract
Background. Therapists frequently advise the use of activity pacing as a coping strategy to manage long-term conditions (eg, chronic low back pain, chronic widespread pain, chronic fatigue syndrome/myalgic encephalomyelitis). However, activity pacing has not been clearly operationalized, and there is a paucity of empirical evidence regarding pacing. This paucity of evidence may be partly due to the absence of a widely used pacing scale. To address the limitations of existing pacing scales, the 38-item Activity Pacing Questionnaire (APQ-38) was previously developed using the Delphi technique. Objective. The aims of this study were: (1) to explore the psychometric properties of the APQ-38, (2) to identify underlying pacing themes, and (3) to assess the reliability and validity of the scale. Design. This was a cross-sectional questionnaire study. Methods. Three hundred eleven adult patients with chronic pain or fatigue participated, of whom 69 completed the test-retest analysis. Data obtained for the APQ-38 were analyzed using exploratory factor analysis, internal and test-retest reliability, and validity against 2 existing pacing subscales and validated measures of pain, fatigue, anxiety, depression, avoidance, and mental and physical function. Results. Following factor analysis, 12 items were removed from the APQ-38, and 5 themes of pacing were identified in the resulting 26-item Activity Pacing Questionnaire (APQ-26): activity adjustment, activity consistency, activity progression, activity planning, and activity acceptance. These themes demonstrated satisfactory internal consistency (Cronbach a=.72-.92), test-retest reliability (intraclass correlation coefficient=.50-.78, P≤.001), and construct validity. Activity adjustment, activity progression, and activity acceptance correlated with worsened symptoms; activity consistency correlated with improved symptoms; and activity planning correlated with both improved and worsened symptoms. Limitations. Data were collected from self-report questionnaires only. Conclusions. Developed to be widely used across a heterogeneous group of patients with chronic pain or fatigue, the APQ-26 is multifaceted and demonstrates reliability and validity. Further study will explore the effects of pacing on patients' symptoms to guide therapists toward advising pacing themes with empirical benefits. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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