TRANSLATION, CROSS-CULTURAL ADAPTATION AND PRELIMINARY EVALUATION OF THE BRAZILIAN VERSIONOF THE PAIN CATASTROPHIZING SCALE-PARENTS

Cavalcante, Julianna Amaral; Viana, Karolline Alves; Costa, Paulo Sucasas; Costa, Luciane Rezende

doi:10.1590/1984-0462/;2018;36;4;00014

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Revista Paulista de Pediatria

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ORIGINAL ARTICLE • Rev. paul. pediatr. 36 (04) • Oct-Dec 2018 • https://doi.org/10.1590/1984-0462/;2018;36;4;00014 copy

TRANSLATION, CROSS-CULTURAL ADAPTATION AND PRELIMINARY EVALUATION OF THE BRAZILIAN VERSIONOF THE PAIN CATASTROPHIZING SCALE-PARENTS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

In Brazil, there is no scale to assess parental catastrophizing about their child’s pain. This study aimed to translate and cross-culturally adapt the Pain Catastrophizing Scale-Parents to the Brazilian Portuguese language, as well as to preliminarily evaluate its psychometric properties among parents/guardians of children with and without a toothache.

Methods:

A cross-sectional study was conducted with 237 parents/other relatives of 237 children. Across-cultural adaptation of the scale into Brazilian Portuguese was carried out according to the universalistic approach. To assess the reliability and validity of the scale, parents/other relatives reported on the child’s toothache and filled out the Brazilian versions of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire.

Results:

There was semantic equivalence with the original version after minor modifications. TheCronbach’s alpha for the 13 items of the scale was 0.83, and the respective test-retest intraclass correlation coefficients ranged from 0.63 to 0.97. The scores obtained from the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire had a low correlation (rho=0.25; p<0.001). Thetotal score of the Pain Catastrophizing Scale-Parents differed significantly (p<0.001) in children with a toothache at night (median: 3.0, 25-75 percentile: 25.0-35.5) compared to those who did not have a toothache at night (25.5; 20.0-31.0).

Conclusions:

The Brazilian version of the Pain Catastrophizing Scale-Parents was acceptable in this preliminary evaluation and can be used in Brazilian clinical and research practice.

Keywords:
Pain; Catastrophization; Child behavior; Validation studies

Issue*	Solution
Questionnaire instructions and items: the word “child” was translated by T1 as “son” and by T2 as “child”.	It was standardized to translate as child, because the questionnaire can be answered by a child’s caregiver and not only by the parents.
Questionnaire instructions: the expression “is in pain” was suggested to be changed to “feel pain” by the expert committee.	Accepted, because it better fits colloquial Brazilian Portuguese.
The word “please”: T1 did not translate or keep the word “please”, explaining that, in Portuguese, the questions are used in imperative format.	For cultural reasons, it was decided against the use of “please”.
Answer options: T1 suggested changing the intensity responses to frequency responses.	To maintain the semantic equivalence and, in the future, if we conduct another study, we will change the response to frequency (never, ever) or agreement (partially agree, strongly agree, etc.)
Answer options: T1 suggested “no feeling, mild feeling, moderate feeling, severe feeling, extreme feeling”, whereas T2 kept the original version options “not at all, mildly, moderately, severely, extremely”.	To change to the “feeling” options. However Prof L. Goubert advised not to keep the word “feeling” because the questionnaire mainly assesses “thoughts”.
T1 removed the personal pronoun “I” in all items and T2 kept it.	To remove the personal pronoun “I” from all of the items to better comply with colloquial Portuguese
Item 5, “When my child is in pain, I cannot stand it anymore”: T1 eliminated the word anymore and T2 kept it.	To eliminate the word “anymore” order to avoid redundancy in Portuguese

Subscales Items (When my child is in pain…)	Frequency of answers* (%)					ICC
Subscales Items (When my child is in pain…)	1	2	3	4	5	ICC
Helplessness
1. I worry all the time about whether the pain will end.	0.4	18.1	11.4	51.1	19.0	0.82
2. I feel I can’t go on like this much longer.	16.9	30.8	16.5	30.0	5.9	0.96
3. It’s terrible and I think it’s never going to get better.	42.2	21.9	11.4	19.4	5.1	0.95
4. It’s awful and I feel that it overwhelms me.	26.2	27.8	9.7	29.5	6.8	0.93
5. I can’t stand it anymore.	34.2	27.8	16.5	16.0	5.5	0.83
12. There is nothing I can do to stop the pain.	40.9	21.5	13.1	19.0	5.5	0.90
Magnification
6. I become afraid that the pain will get worse.	1.7	27.8	11.0	40.5	19.0	0.63
7. I keep thinking of other painful events.	27.8	33.3	8.9	24.1	5.9	0.95
13. I wonder whether something serious may happen.	13.9	30.0	8.9	38.4	8.9	0.97
Rumination
8. I want the pain to go away.	0	5.5	4.6	51.9	38.0	0.91
9. I can’t keep it out of my mind.	8.0	21.9	11.0	40.5	18.6	0.90
10. I keep thinking about how much he/she is suffering.	1.7	10.1	11.4	56.1	20.7	0.92
11. I keep thinking about how much I want the pain to stop.	4.2	4.6	4.2	61.2	25.7	0.85

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[1] *Corresponding author. E-mail: lsucasas@ufg.br (P.S. Costa).