Assessment of pain cognitions in cancer patients with chronic pain

Although reports suggest that beliefs about pain play an important role in the adjustment and pain experience of non-cancer patients, the impact of co gnitions on the pain experience is unknown in cancer patients. This study e xamined the factor structure, reliability, and validity, of the Pain Cognit ion List-Experimental version, a measure developed to assess patients' self -statements about pain and the extent to which patients are effective in de aling with the pain. The Pain Cognition List-Experimental version was admin istered to 313 cancer patients during hospitalization. Confirmatory factor analysis was conducted to evaluate the adequacy of fit for the original fiv e factors. Because of a failure to replicate the factors, exploratory facto r analysis was conducted, finding the factors Pain Impact, Social Compariso n, Acquiescence, and Outcome Efficacy. The internal consistency for the fac tor Pain Impact was high (r = 0.89), while the other three factors showed l ow reliability. The factor Catastrophizing, usually an important factor in non-cancer patients, did not emerge. No differences were found across sex. The factors Pain Impact and Acquiescence provided evidence for concurrent v alidity. Patients with district nursing showed higher scores on the factors Pain Impact and Acquiescence, and higher scores on Pain Impact and Acquies cence were associated with higher pain intensity scores. This study was an attempt to evaluate pain cognitions and beliefs in cancer patients. It is c oncluded that the Pain Cognition List for non-cancer patients cannot be eas ily used in cancer pain patients and that evaluation of pain cognitions in cancer patients is useful. Health care providers evaluating pain in cancer patients with chronic pain need to be aware of the impact pain cognitions h ave on patients' pain experience. Although more research is needed, measuri ng pain cognitions should be considered. J Pain Symptom Manage 2001; 22:911 -924. (C) U.S. Cancer Pain Relief Committee, 2001.