Validation of the Chinese version of the Brief Pain Inventory in patients with knee osteoarthritis

• Published in: Journal of orthopaedic surgery and research 2023-09, Vol.18 (1), p.1-720, Article 720
• Main Authors: Wang, Shunxing, Yao, Shuxin, Shang, Lei, Xu, Chao, Ma, Jianbing
• Format: Article
• Language: English
• Subjects: Adaptation; Arthritis; Bilingualism; Brief Pain Inventory; Care and treatment; Chinese; Chronic pain; Correlation analysis; Factor analysis; Health aspects; Interpreters; Knee; Knee osteoarthritis; Orthopedics; Osteoarthritis; Pain; Pain measurement; Patients; Psychometric properties; Quality of life; Quantitative psychology; Questionnaires; Validation studies; Validity
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-023-04218-1

Background Knee osteoarthritis (KOA) primarily presents with symptoms of pain and compromised functionality. Pain is a subjective manifestation that necessitates the employment of reliable evaluation tools for practical assessment, thereby enabling the formulation of appropriate interventional strategies. The Brief Pain Inventory (BPI) is a widely utilized questionnaire for evaluating the status of chronic pain. The purpose of the present study is to translate the short form of BPI into Chinese version (BPI-CV) and conduct cross-cultural adaptation to evaluate the psychometric characteristics of BPI-CV in KOA patients. Methods BPI-CV was translated and cross-culturally adapted according to internationally recognized guidelines. A cohort comprising 150 patients diagnosed with KOA successfully completed the demographic questionnaire, BPI-CV, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the EuroQoL Group's five-dimension questionnaire (EQ-5D). Internal consistency and test-retest analysis were used to evaluate the reliability. The internal consistency of the scale items was evaluated by calculating the Cronbach's [alpha] value (> 0.7). We chose to employ two scales commonly used in the evaluation of KOA patients: the disease-specific WOMAC scale and the universal EQ-5D scale. Construct validity was determined through Pearson correlation analysis, comparing BPI scores with those obtained from the WOMAC and EQ-5D scales. Exploratory factor analysis was used to structural validity. Results The BPI-CV was well accepted with no ceiling or floor effect. Cronbach's [alpha] for assessing internal consistency was 0.894. Test-retest reliability was excellent with an ICC of 0.852 (95%CI 0.785-0.905). The BPI-CV showed moderate to strong correlations with the pain dimension (r = 0.496-0.860) and the functional interference dimension (r = 0.517-0.712) of the WOMAC and the EQ-5D (r = 0.527-0.743). Three factors resulted using exploratory factor analysis: pain severity, activity interference, and emotional interference, accounting for 79.0% of the total variance. Standard error of measurement was 0.539. Conclusion BPI-CV has good feasibility, reliability, and validity. It can be recommended for KOA patients in mainland China. Keywords: Brief Pain Inventory, Knee osteoarthritis, Pain measurement, Chinese, Psychometric properties