Tradução, adaptação transcultural e análise das propriedades de medida do Psychological Inflexibility in Pain Scale (PIPS) em pacientes brasileiros com dor oncológica

Abstract

Introduction: A recent global estimate indicates that 18 million new cases of cancer and 9.6 million deaths from cancer occurred worldwide. Many of these cancer cases progress with pain. The Psychological Inflexibility in Pain Scale (PIPS) was developed to measure psychological inflexibility in people with chronic pain considering two domains: “pain avoidance” and “cognitive fusion”. PIPS has already been validated in several countries, being adapted to Spanish, German, Persian, Japanese and Chinese. Objective: Translate, cross-culturally adapt and analyze the measurement properties of the PIPS in Brazilian patients with cancer pain. Methodology: A translation, cross-cultural adaptation and questionnaire validation study was carried out in the Pain and Palliative Care sector of the Maranhão Cancer Hospital and Aldenora Bello Cancer Hospital (São Luís, Maranhão), divided into two phases: translation and cross-cultural adaptation of the PIPS, and analysis of the measurement properties of the cross-culturally adapted version. The measurement properties tested here were: structural validity, construct validity, reliability and internal consistency. In addition to the PIPS, the following assessment instruments were applied: Pain Catastrophizing Scale (PCS), Edmonton Symptom Assessment Scale (EASE), Barthel Scale (BE) and the Hospital Anxiety and Depression Scale (EHAD). Results: The sample consisted of 122 patients, with the majority of the sample being women (65.6%), with a mean age of ~49 years, married (50.8%) and with complete primary education (46.7%). %). It was observed that the majority had uterine cancer (23%) and leukemia (9.8%). Regarding the evolution of the participants, cases without metastasis (80.3%) and curative care (95.9%) predominated. Adequate reliability was observed for both domains, with an ICC of 0.8 for the cognitive fusion domain and 0.95 for the avoidance domain. There was a correlation with a magnitude greater than 0.30 with the depression domain of the EHAD and correlations with a magnitude less than 0.30 with the anxiety domain of the EHAD, with the PCS domains and with the Barthel index. The PIPS cognitive fusion domain did not correlate with the instruments of the present study (p > 0.05), nor did it correlate with the avoidance domain, both PIPS domains, with a correlation magnitude of 0.169 (p = 0.079). No ceiling or floor effects were observed. Conclusion: The Brazilian version of the PIPS is reliable and valid for measuring avoidance in patients with cancer pain, however, the cognitive fusion domain is not adequate.