Measurement Properties of the Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) in Pain-related Musculoskeletal Conditions: A Systematic Review.

OBJECTIVE: The objective of this study was to systematically locate, critically appraise, and summarize clinical measurement research addressing the use of Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) in pain-related musculoskeletal (MSK) conditions. MATERIALS AND METHODS: We systematically searched 4 databases (Medline, CINAHL, EMBASE, and SCOPUS) and screened articles to identify those reporting the psychometric properties (eg, validity, reliability) and interpretability (eg, minimal clinically important difference) of BPI-SF and SF-MPQ-2 as evaluated in pain-related MSK conditions. Independently, 2 reviewers extracted data and assessed the quality of evidence with a structured quality appraisal tool and the updated COSMIN guidelines. RESULTS: In all, 26 articles were included (BPI-SF, n=17; SF-MPQ-2, n=9). Both tools lack reporting on their cross-cultural validities and measurement error indices (eg, standard error of measurement). High-quality studies suggest the tools are internally consistent (α=0.83 to 0.96), and they associate modestly with similar outcomes (r=0.3 to 0.69). Strong evidence suggests the BPI-SF conforms to its 2-dimensional structure in MSK studies; the SF-MPQ-2 4-factor structure was not clearly established. Seven reports of high-to-moderate quality evidence were supportive of the BPI-SF known-group validity (n=2) and responsiveness (n=5). One report of high quality established the SF-MPQ-2 responsiveness. DISCUSSION: Evidence of high-to-moderate quality supports the internal consistency, criterion-convergent validity, structural validity, and responsiveness of the BPI-SF and SF-MPQ-2 and establishes their use as generic multidimensional pain outcomes in MSK populations. However, more studies of high quality are still needed on their retest reliability, known-group validity, cross-cultural validity, interpretability properties, and measurement error indices in different MSK populations.

Reproducibility: reliability and agreement parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in patients with musculoskeletal shoulder pain.

BACKGROUND: The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to capture, evaluate and discriminate pain from neuropathic and non-neuropathic sources. A recent systematic review found insufficient psychometric data with respect to musculoskeletal (MSK) health conditions. This study aimed to describe the reproducibility (test-retest reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. METHODS: Eligible patients with shoulder pain from MSK sources completed the SF-MPQ-2: at baseline (n = 195), and a subset did so again after 3-7 days (n = 48), if their response to the Global Rating of Change (GROC) scale remained unchanged. Cronbach alpha (α) and intraclass correlation coefficient (ICC2,1), and their related 95% CI were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland-Altman (BA) plots were used to assess agreement. RESULTS: Cronbach α ranged from 0.83 to 0.95 suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC2,1 scores were found in support of the total scale (0.95) and continuous subscale (0.92) scores; the remaining subscales displayed good ICC2,1 scores (0.78-0.88). Bland-Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13-0.19). While the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90individual = 1.2 and MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range 0.7-1; MDC90individual: range 1.7-2.3; MDC90group: range 0.4-0.5). CONCLUSION: Good reproducibility supports the SF-MPQ-2 domains for augmented or independent use in MSK-related shoulder pain assessment, with the total scale displaying the best reproducibility coefficients. Additional research on the validity and responsiveness of the SF-MPQ-2 is still required in this population.

Reproducibility: Reliability and Agreement Parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in Patients with Musculoskeletal Shoulder Pain.

Background: The Revised Short-Form McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to evaluate neuropathic and nonneuropathic pain. A recent systematic review found insufficient psychometric data with respect to musculoskeletal health conditions. Aims: The aim of this study was to describe the reproducibility (reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. Methods: Eligible patients with shoulder pain from musculoskeletal (MSK) sources completed the SF-MPQ-2 at baseline (n = 195), and a subset did so again after 3 to 7 days (n = 48) if their response to the global rating of change scale remained unchanged. Cronbach's alpha (α) and intraclass correlation coefficient (ICC[2,1]) were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland-Altman plots were used to assess agreement. Results: Cronbach's α ranged from 0.83 to 0.95, suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC(2,1) scores were found in support of the total (0.95) and continuous (0.92) subscales; the remaining subscales displayed good ICC(2,1) scores (0.78-0.88). Bland-Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13 to 0.19). Though the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90 = 1.2, MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range, 0.7-1; MDC90: range, 1.7-2.3; MDC90group: range, 0.4-0.5). Conclusions: The SF-MPQ-2 provides good to excellent test-retest reliability for multidimensional pain assessment among patients with musculoskeletal shoulder pain conditions.

Contexte: Le Questionnaire abrégé révisé de McGill sur la douleur, version 2 (SF-MPQ-2) est une mesure multidimensionnelle des résultats conçue pour évaluer la douleur neuropathique et non neuropathique. Une revue systématique récente a révélé l'insuffisance des données psychométriques relatives aux troubles musculo-squelettiques.Objectifs: décrire la reproductibilité (fiabilité et concordance) et la cohérence interne du SF-MPQ-2 pour une utilisation chez les patients souffrant de douleurs musculo-squelettiques à l'épaule.Méthodes: Les patients admissibles souffrant de douleurs à l'épaule provenant de sources musculo-squelettiques ont répondu au SF-MPQ-2 : au départ (n = 195), et un sous-ensemble l'a fait à nouveau après une période de 3 à 7 jours (n  =  48), si leur réponse pour l'échelle de l'évaluation globale du changement était restée inchangée. Le coefficient alpha de Cronbach (α) et le coefficient de corrélation intra-classe (CCI2, 1) ont été calculés. L'erreur-type de mesure (ETM), le changement minimal détectable (CMD90) pour le groupe et pour l'individu, et les graphiques de Bland-Altman (BA) ont été utilisés pour évaluer la concordance.Résultats: L'alpha de Cronbach se situait entre 0,83 à 0,95, ce qui indique une cohérence interne très satisfaisante dans les domaines du SF-MPQ-2. D'excellents scores CCI2, 1 ont été trouvés à l'appui des sous-échelles totale (0,95) et continue (0,92) ; les autres sous-échelles ont affiché de bons scores CCI2, 1 (0,78 à 0,88). L'analyse de Bland-Altman n'a révélé aucun biais systématique entre les résultats du test et ceux du retest (différence moyenne = 0,13 à 0,19). Bien que les meilleurs coefficients de concordance aient été observés sur l'échelle totale (ETM  =  0,5 ; CMD90 = 1,2 et groupe CMD90 = 0,3), ils étaient acceptables pour les deux sous-échelles du SF-MPQ-2 (ETM :   entre 0,7 et 1 ; ETM90 :   entre 1,7 et 2,3 ; groupe CMD90 :   entre 0,4 et 0,5).Conclusions: Le SF-MPQ-2 offre une fiabilité test-retest allant de bonne à excellente pour l'évaluation multidimensionnelle de la douleur chez les patients souffrant de douleurs musculo-squelettiques de l'épaule.

The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria.

INTRODUCTION: The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. OBJECTIVES: To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. METHOD: This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. RESULTS: The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. CONCLUSIONS: Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.