The Pain Catastrophizing Scale (PCS) and Short Health Anxiety Inventory (SHAI) can help hand surgeons identify opportunities for psychologic support, but they are time-consuming. If easier-to-use tools were available and valid, they might be widely adopted. We tested the validity of shorter versions of the PCS and SHAI, the PCS-4 and the SHAI-5, and found that there were small, but significant differences between the mean scores for the SHAI-18 and SHAI-5 (SHAI-18 higher) and PCS-13 and PCS-4 (PCS-4 higher) (1). However, content validity, construct convergent validity, and criterion validity were established for the short versions of the PCS and SHAI. Using shorter forms creates small differences in mean values that we believe are unlikely to affect study results and are more efficient and advantageous because of the decreased responder burden.

One of our studies assessed whether there was a difference in score between paper and telephone administration of disability and psychological questionnaires relevant to patients with an upper extremity illness. There were small but significant differences between paper and phone administration of the short version of the Disabilities of the Arm, Shoulder, and Hand scores and pain scores, but not the Patient Health Questionnaire-2, Short Health Anxiety Inventory-5, and Pain Catastrophizing Scale-4 (2). It was concluded that shorter questionnaires can be used to assess disability and psychological factors by phone. Phone administration of measures of disability and psychological factors can replace paper administration in studies that do not require in-person examination.

Pain is one of the most common presenting symptoms in the practice of a hand and upper extremity surgeon, highly influenced by coping strategies. There are several measures assessing ineffective pain coping strategies, often used in combination in research studies. These measures all correlate highly both with each other and with symptom intensity and magnitude of disability in patients with upper limb illness. Another study aimed to determine if distinct measures address a single common factor: coping strategies in response to nociception. Our goal was to identify one common aspect of human illness behavior measured by the Pain Catastrophizing Scale (PCS), the Psychological Inflexibility in Pain Scale (PIPS), the Patient-Reported Outcomes Measurement Information System-Pain Interference (PROMIS-PI) Computer Adaptive Test (CAT), and the Pain Self-Efficacy Questionnaire (PSEQ). Secondarily, we aimed to determine which of the four questionnaires is most psychometrically sound.

Prior to their visit with a clinician, 134 patients completed the four questionnaires in random order. We found that there was one underlying construct measured by all four questionnaires, namely, coping strategies in response to nociception, which negatively impacts upper extremity disability (3).  

References

1. Bot AG, Becker SJ, van Dijk CN, Ring D, Vranceanu AM. Abbreviated Psychologic Questionnaires Are Valid in Patients With Hand Conditions. Clin Orthop Relat Res. 2013 Aug 3. [Epub ahead of print] PubMed PMID: 23913341
2. Bot AG, Becker SJ, Mol MF, Ring D, Vranceanu AM. Validation of Phone Administration of Short-Form Disability and Psychology Questionnaires. J Hand Surg Am. 2013 May 24. doi:pii: S0363-5023(13)00422-X. 10.1016/j.jhsa.2013.03.033.[Epub ahead of print] PubMed PMID: 23707596.
3. Kortlever JT, Janssen SJ, van Berckel MM, Ring D, Vranceanu AM. What Is the Most Useful Questionnaire for Measurement of Coping Strategies in Response to Nociception? Clin Orthop Relat Res. 2015 Jun 24. [Epub ahead of print] PubMed PMID: 26105152.