Further evaluation of the pain stages of change questionnaire: is the transtheoretical model of change useful for patients with chronic pain?

Patient readiness to adopt new beliefs and coping responses to pain may pre dict response to multidisciplinary or cognitive-behavioral pain treatments that emphasize changes in beliefs and coping behaviors. According to the tr anstheoretical model of change, individuals go through specific stages in t he process of changing maladaptive behaviors. Based on this model, Kerns et al. (1997) (Kerns RD, Rosenberg R, Jamison RN, Caudill MA, Haythornthwaite J. Readiness to adopt a self-management approach to chronic pain: the Pain Stages of Change Questionnaire (PSOCQ). Pain 1997;72:227-234) developed a measure of readiness to adopt a self-management approach to pain problems ( the Pain Stages of Change Questionnaire; PSOCQ) and provided preliminary da ta supporting the validity of the measure. The current study sought to furt her evaluate the PSOCQ by determining the generalizability of these prelimi nary findings and the ability of the PSOCQ to classify persons with chronic pain into specific stages of readiness to self-manage pain. One hundred te n patients with diverse chronic pain problems, and 119 patients with fibrom yalgia completed the PSOCQ and two measures of pain-related beliefs and cop ing prior to entry into two separate multidisciplinary pain programs. The i nternal consistency and concurrent validity of the PSOCQ subscales were lar gely replicated, supporting the validity of the subscales as measures of re adiness to self-manage pain. However, the PSOCQ demonstrated less utility a s a tool for classifying individuals into one of four specific stages of re adiness to adopt a self-management approach. This result may be due to the classification procedure used in the current study, the characteristics of the samples in the study, specific limitations of the measure, and/or limit ations in the applicability of the transtheoretical model of change to pati ents with chronic pain. (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.