Adaption Of Patterns Of Activity Measure-pain And The Effect Of Chronic Pain-related Activity Patterns On The Functioning In Patients With Spine Degenerative Disease

Objective 1.To translate the English version of Patterns of Activity Measure-Pain(POAM-P)into Chinese.2.To evaluate the reliability and validity of the Chinese version of POAM-P.3.To determine whether the pain-related activity patterns(avoidance,overdoing and pacing)are predicting factors for chronic pain patients’ functions.Methods 1.In accordance with the Brislin translation principle,a final Chinese version of the pain-related activity pattern scale was developed.From October 2017 to December 2018,data were collected from chronic pain patients(pain duration ≥3 months)at the Department of Spinal Surgery of the Tianjin Medical University General Hospital and the Department of Spinal Surgery and Pain Clinic of Tianjin Hospital.The Puestionnaires used included sociological demographic data table,pain related data table(including pain durations,pain levels,number of pain points and pain sites),Tampa Scale for Kinesiophobia,and Chinese version of Patterns of Activity Measure-Pain scale.To verify the psychological characteristics of the Chinese version of Patterns of Activity Measure-Pain,the reliability was tested using the test-retest reliability and internal consistency,and the validity was tested using the structural validity and the criterion-related validity.2.From January 2018 to April 2018,data were collected from patients with lumbar degenerative disease who had pain duration of and more than 3 months at the Department of Spinal Surgery of Tianjin Medical University General Hospital and the Department of Spinal Surgery of Tianjin Hospital.The Puestionnaires used included: sociological demographic data table,pain related data table(including pain duration,pain levels),Tampa Scale for Kinesiophobia,Chinese version of Patterns of Activity Measure-Pain scale,Pain Catastrophizing Scale,Chronic Pain Acceptance Puestionnaire-8,General self-efficacy scale,social support rate scale,and The 12-items Short Form Health Survey.Univariate analysis was used to identify the factors affecting the physical function and psychological function of patients with chronic pain.The statistically significant sociological demographic data,pain-related data and other factors in the univariate analysis were used as independent variables,with the score of physical function scores and psychological functions was dependent variables,two hierarchical multiple linear regression analysis was performed to determine how the pain-related activity pattern affects the patient’s functional status.Results 1.The stage of Chinesization According to the Brislin translation principle,the Chinese version of Patterns of Activity Measure-Pain scale includes 30 items.The results of the item analysis showed that the Chinese version of Patterns of Activity Measure-Pain scale was able to identify high and low groups(P<0.001).A total of 3 common factors were extracted by exploratory factor analysis,and the cumulative contribution rate was 73.32%.The patient’s pain levels and catastrophic thought scores were used as the calibration related validity index,pain levels were corrected with avoidance activity pattern,overdoing activity pattern,and pacing activity pattern.The correlation coefficients were 0.39,0.22,and-0.28,respectively(P<0.001).The correlation coefficients of Catastrophizing scores with avoidance activity pattern,overdoing activity pattern and pacing activity patterns were 0.43,0.26,and-0.58,respectively(P<0.001).The re-test correlation coefficients of avoidance activity pattern,overdoing activity pattern and pacing activity pattern were 0.76(P<0.001),0.61(P<0.01),0.72(P<0.001),and the Cronbach’s α coefficient of the total scale was 0.85.The Cronbach’s α coefficients of the three domains of avoidance activity pattern,overdoing activity pattern and pacing activity pattern were 0.95,0.79,and 0.86,respectively.2.The stage of application A total of 199 Puestionnaires were collected.Among the 199 respondents,there were more women,accounting for 55.80%.The age ranged from 23 to 81 years old,with a median of 61.00 years,Puartiles P25 and P75 were 48.00 years old and 74.00 years old,respectively.Among the three activity patterns,the score of the avoidance activity mode ranged from 3.00 to 40.00 points,the median was 16.00,and the Puartiles P25 and P75 were 10.00 and 29.00,respectively.The overactive mode score ranged from 3.00 to 40.00 points with a median of 13.00 and Puartiles P25 and P75 of 8.00 and 27.00,respectively.The adjusted activity mode score ranged from 4.00 to 36.00,with a median of 19.00 and P25 and P75 of 12.00 and 29.00,respectively.There were 65 patients who were led by the avoidance activity pattern;78 patients who were led by the overdoing activity pattern;55 patients who were led by the pacing activity pattern;and 1 patient can’t be determined which activity pattern is dominant activity pattern.3.The effects of pain-related activity patterns on chronic pain patients’ functions The results of hierarchical multivariate current regression analysis showed that all the independent variables included accounted for 57.00% of the total variation.Three different pain-related activity patterns are factors influencing the patient’s physical function status,explaining 8.00% of the total variation.The results of hierarchical multivariate line regression analysis showed that all the independent variables included accounted for 39.00% of the total variation.The avoidance activity pattern and the adaptation activity pattern in the three different pain-related activity patterns are the influencing factors of the patient’s physical function status,which can explain 10.00% of the total variation.Conclusions 1.The Chinese version of Patterns of Activity Measure-Pain scale has good reliability and validity,and can be used in patients with lumbar degenerative diseases in China.2.Among the patients with lumbar degenerative diseases,most patients with the overdoing activity pattern,the second was avoidance activity pattern.3.In order to improve the patient’s physical function,medical staff should guide the pain patients to avoid avoidance activity pattern and overdoing activity pattern,and should focus on patients on who are women,older age and have severe pain levels.In order to improve the patient’s psychological function,medical staff should guide the pain patients to adopt pacing activity pattern and avoid the avoidance activity pattern,and pay attention to patients who are older age,have longer pain time,low self-efficacy and low social support.It is recommended that more researches should be conducted in the future to determine how the pattern of overdoing activity pattern affects the psychological function of patients with chronic pain.