The McGill Quality of Life Questionnaire-Revised (MQOL-R). Psychometric properties and validation of a Brazilian version on palliative care patients: a cross-sectional study.

BACKGROUND: To assess the psychometric properties, including internal consistency, construct validity, criterion validity, criterion-group validity, and responsiveness, the Reviewed McGill Quality of Life Questionnaire (MQOL-R), into Brazilian Portuguese-(BrP). Also, to analyze the relationship of the BrP-MQOL-R with the scores on the Karnofsky Performance Scale (KPS) and on the Numerical Pain Scale (NPS 0-10). METHODS: The BrP-MQOL-R was administered to a sample of 146 adults (men = 78). A team of experts translated the MQOL-R according to international guidelines. Convergent validity and Confirmatory factor analysis (CFA) was performed. RESULTS: The BrP-MQOL-R Cronbach's alpha was 0.85. CFA supported the original four-factor structure, with the following revised model fit-indices: PCLOSE = 0.131, Tucker-Lewis Index (TLI) rho 2 = 0.918, incremental fit index (IFI) delta 2 = 0.936. The convergence validity is supported by a significant correlation between BrP-MQOL-R total scores and their subscales with KPS and with the single item related to the quality of life. And by a converse correlation with the pain scores in the NPS (0-10). Receiver operator characteristics (ROC) analysis showed subjects with KPS equal to or lower than 30% could be discriminated from those with scores on KPS higher than 30% by an area under the curve (AUC) = 0.71, sensitivity = 97%, and specificity = 92%). CONCLUSION: The BrP-MQOL-R proves to be a reliable instrument for assessing the quality of life (QOL) in palliative care (PC), with primary evidence of validity. BrP-MQOL-R presented adequate discriminate properties to identify distinct conditions that impact the QOL in PC.

Distinct aspects of pain catastrophizing according to chronic pain syndromes

Introduction: Catastrophizing is the tendency to magnify the threat value of pain and has been associated with measures of physical and psychological disability among individuals with several pain conditions. The aim of this study was to investigate whether pain catastrophizing is differentially associated with distinct pain syndromes. Methods: This is a cross-sectional study including 158 patients (40 with fibromyalgia, 25 with myofascial pain syndrome, 33 with chronic tensional type headache, 33 with endometriosis, and 27 with knee osteoarthritis) and 93 healthy subjects. The recruitment procedure occurred in concurrence with randomized controlled trials. Participants answered the following instruments: Brazilian Portuguese Pain-Catastrophizing Scale, Beck Depression Inventory II, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, visual analogue scale for pain, as well as a sociodemographic questionnaire. Results: For the total pain catastrophizing score, patients with endometriosis had significantly more catastrophizing thoughts than knee osteoarthritis (p < 0.05). Healthy participants had lower scores than any clinical group. More interestingly were the dimensions of pain catastrophizing, which showed significant differences in more than two groups, especially magnification scores, since these scores were able to discriminate, in a particular way, the majority of clinical samples from each other. We also observed differences between rumination, magnification and helplessness scores in all groups, suggesting that the characteristics of pain catastrophizing are distinct according to the pain disorder. Conclusions: The results suggest that dimensions of pain catastrophizing differ between pain syndromes. Therefore, it is important that researchers and clinicians focus on cognitive and emotional aspects of pain perception to have more successful interventions.