Assessing attitudes toward and beliefs about pain among Chinese patients with chronic pain: validity and reliability of the Chinese version of the Pain Beliefs and Perceptions Inventory (ChPBPI)

Context: Research consistently has evidenced the reliability and validity of the Pain Beliefs and Perceptions Inventory (PBPI). The instrument, however, has not been tested for its applicability and validity in non-Western populations.

Objectives: To translate the English language version of the PBPI into Chinese (ChPBPI) and to evaluate its reliability, validity, and factor structure.

Methods: A total of 208 Chinese patients with mixed origin chronic pain were recruited from an orthopedic specialist outpatient clinic associated with a public hospital in Hong Kong. In addition to the ChPBPI, patients were administered the Chronic Pain Grade (CPG) questionnaire, the Pain Catastrophizing Scale (PCS), the Center for Epidemiological Studies-Depression Scale (CES-D), and questions assessing sociodemographic characteristics.

Results: Using the original factor structure of the PBPI as a model, confirmatory factor analyses revealed that all four ChPBPI scales demonstrated good data-model fit (CFI≥0.92) and adequate internal consistency (Cronbach's αs: 0.60-0.76). The four ChPBPI scales showed significant positive correlations with CES-D, PCS, pain intensity, and disability. Results of hierarchical multiple regression analyses showed that the ChPBPI scales predicted concurrent depression (F(4, 187)=6.01, P<0.001), pain intensity (F(4, 186)=4.61, P<0.01), and pain disability (F(4, 190)=3.54, P<0.05) scores.

Conclusion: These findings support the factorial validity of the scales of the ChPBPI, and its reliability and construct validity. Now clinically relevant beliefs about pain can be assessed among Chinese patients with chronic pain.