Translation, cross-cultural adaptation and validation of the Pain Attitudes Questionnaire - revised into Brazilian Portuguese in patients with chronic cancer pain

ObjectiveTo translate, culturally adapt, and validate the Pain Attitudes Questionnaire - Revised (PAQ-R) into Brazilian Portuguese for patients with chronic cancer pain.DesignQuestionnaire validation study.SettingMaranhão Oncology Hospital and Aldenora Bello Hospital (São Luís, Maranhão, Northeast Brazil).Participants165 patients with chronic cancer pain, of both sexes, aged 18 years or older.Main MeasuresThe Barthel Index, Hospital Anxiety and Depression Scale (HADS), and Pain Catastrophizing Scale (PCS) were used for clinimetric evaluation. The Edmonton Symptom Assessment System (ESAS) was used to characterize the sample. The measurement properties evaluated in this study included cross-cultural validity, structural validity, construct validity, reliability, and internal consistency.ResultsThe study included 165 cancer patients. The internal structure of the PAQ-R, consisting of five domains and 23 items, was adequate (comparative fit index = 0.95, Tucker-Lewis index = 0.94, root mean square error of approximation = 0.08, chi-square/degrees of freedom = 2.04). Test-retest reliability was satisfactory (ICC = 0.82 to 0.89), as was internal consistency (Cronbach's alpha = 0.70 to 0.94). Expected correlation magnitudes (rho ≤ 0.384, p < 0.05) were observed between all PAQ-R domains and functional independence, between the stoic-fortitude domain and depression, and between catastrophizing and the stoic-fortitude, stoic-superiority, and cautious-self-doubt domains of the PAQ-R.ConclusionThe Brazilian Portuguese version of the PAQ-R, with five domains and 23 items, demonstrated adequate construct validity, reliability, and internal consistency for use in patients with chronic cancer pain.