Skip to main content
SpringerLink
Log in

Cross-cultural adaptation and validation of a Brazilian Portuguese version of the chronic pain grade

  • Brief Communication
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To verify the reliability and validity of a Brazilian Portuguese version of the chronic pain grade (CPG-Br).

Methods

Cultural adaptation was made in accordance with established guidelines, with modifications aiming at improving this process. Adaptations were made based on interviews with 45 chronic pain patients from São Paulo city. Validation was studied by concurrent application of the short-form-36 health survey (SF-36) and other questionnaires to 283 participants with chronic pain from the general population. Temporal stability was verified by a second application to 131 individuals.

Results

Factor analysis resulted in a two-factor solution with factors named characteristic pain intensity and activity limitation due to pain. Alpha coefficients of 0.78 and 0.70 and intraclass correlation coefficients of 0.76 and 0.72 for each factor indicated good internal consistency and temporal stability. Significant correlations between CPG-Br and SF-36, Roland-Morris disability questionnaire and neck disability index scores were noted. A consistent linear trend was also observed between pain grades and SF-36 scores. Frequency of use of pain medications and of pain-related medical visits increased with pain grade.

Conclusion

This Brazilian Portuguese version of the chronic pain grade, tested on a sample of the Brazilian population, demonstrated good reliability and validity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10, 287–333.

    Article  PubMed  Google Scholar 

  2. Elliott, A. M., Smith, B. H., Penny, K. I., Smith, W. C., & Chambers, W. A. (1999). The epidemiology of chronic pain in the community. Lancet, 354, 1248–1252.

    Article  CAS  PubMed  Google Scholar 

  3. Verhaak, P. F., Kerssens, J. J., Dekker, J., Sorbi, M. J., & Bensing, J. M. (1998). Prevalence of chronic benign pain disorder among adults: A review of the literature. Pain, 77, 231–239.

    Article  CAS  PubMed  Google Scholar 

  4. Gureje, O., Von Korff, M., Simon, G. E., & Gater, R. (1998). Persistent pain and well-being: A World Health Organization Study in Primary Care. Journal of the American Medical Association, 280, 147–151.

    Article  CAS  PubMed  Google Scholar 

  5. Moore, R., & Brødsgaard, I. (1999). Cross-cultural investigations of pain. In I. K. Crombie, P. R. Croft, S. J. Linton, L. LeResche, & M. Von Korff (Eds.), Epidemiology of pain (pp. 53–79). Seattle: International Association for the Study of Pain.

    Google Scholar 

  6. Smith, B. H., Macfarlane, G. J., & Torrance, N. (2007). Epidemiology of chronic pain, from the laboratory to the bus stop: Time to add understanding of biological mechanisms to the study of risk factors in population-based research? Pain, 127, 5–10.

    Article  PubMed  Google Scholar 

  7. Cassidy, J. D., Côté, P., Carroll, L. J., & Kristman, V. (2005). Incidence and course of low back pain episodes in the general population. Spine, 30, 2817–2823.

    Article  PubMed  Google Scholar 

  8. Elliott, A. M., Smith, B. H., Hannaford, P. C., Smith, W. C., & Chambers, W. A. (2002). The course of chronic pain in the community: Results of a 4-year follow-up study. Pain, 99, 299–307.

    Article  CAS  PubMed  Google Scholar 

  9. UK BEAM Trial Team. (2004). United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: Cost effectiveness of physical treatments for back pain in primary care. British Medical Journal, 329, 1381–1385.

    Article  Google Scholar 

  10. Von Korff, M., Balderson, B. H., Saunders, K., Miglioretti, D. L., Lin, E. H., Berry, S., et al. (2005). A trial of an activating intervention for chronic back pain in primary care and physical therapy settings. Pain, 113, 323–330.

    Article  Google Scholar 

  11. Carroll, L. J., Cassidy, J. D., & Côté, P. (2004). Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain, 107, 134–139.

    Article  PubMed  Google Scholar 

  12. Mercado, A. C., Carroll, L. J., Cassidy, J. D., & Côté, P. (2005). Passive coping is a risk factor for disabling neck or low back pain. Pain, 117, 51–57.

    Article  PubMed  Google Scholar 

  13. Kreling, M. C., Cruz, D. A., & Pimenta, C. A. (2006). Prevalence of chronic pain in adult workers. Revista Brasileira de Enfermagem, 59, 509–513.

    Article  PubMed  Google Scholar 

  14. Sá, K., Baptista, A. F., Matos, M. A., & Lessa, I. (2009). Prevalence of chronic pain and associated factors in the population of Salvador, Bahia. Revista de Saude Publica, 43, 622–630.

    PubMed  Google Scholar 

  15. Von Korff, M., Ormel, J., Keefe, F. J., & Dworkin, S. F. (1992). Grading the severity of chronic pain. Pain, 50, 133–149.

    Article  Google Scholar 

  16. Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25, 3186–3191.

    Article  CAS  PubMed  Google Scholar 

  17. Guillemin, F., Bombardier, D., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46, 1417–1432.

    Article  CAS  PubMed  Google Scholar 

  18. Ciconelli, R. M., Ferraz, M. B., Santos, W., Meinão, I., & Quaresma, M. R. (1999). Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Revista Brasileira de Reumatologia, 39, 143–150.

    Google Scholar 

  19. Nusbaum, L., Natour, J., Ferraz, M. B., & Goldenberg, J. (2001). Translation, adaptation and validation of the Roland-Morris questionnaire—Brazil Roland-Morris. Brazilian Journal of Medical and Biological Research, 34, 203–210.

    Article  CAS  PubMed  Google Scholar 

  20. Cook, C., Richardson, J. K., Braga, L., Menezes, A., Soler, X., Kume, P., et al. (2006). Cross-cultural adaptation and validation of the Brazilian Portuguese version of the neck disability index and neck pain and disability scale. Spine, 31, 1621–1627.

    Article  PubMed  Google Scholar 

  21. Pett, M. A., Lackey, N. R., & Sullivan, J. J. (2003). Rotating the factors. In M. A. Pett, N. R. Lackey, & J. J. Sullivan (Eds.), Making sense of factor analysis (pp. 131–166). Thousand Oaks: Sage.

    Google Scholar 

  22. Salaffi, F., Stancati, A., & Grassi, W. (2006). Reliability and validity of the Italian version of the Chronic Pain Grade questionnaire in patients with musculoskeletal disorders. Clinical Rheumatology, 25, 619–631.

    Article  PubMed  Google Scholar 

  23. Smith, B. H., Penny, K. I., Purves, A. M., Munro, C., Wilson, B., Grimshaw, J., et al. (1997). The Chronic Pain Grade questionnaire: Validation and reliability in postal research. Pain, 71, 141–147.

    Article  CAS  PubMed  Google Scholar 

  24. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Article  CAS  PubMed  Google Scholar 

  25. Cicchetti, D. V., & Sparrow, S. A. (1981). Developing criteria for establishing interrater reliability of specific items: Applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86, 127–137.

    CAS  PubMed  Google Scholar 

  26. Ware, J. E., Kosinski, M., Gandek, B., Aaronson, N. K., Apolone, G., Bech, P., et al. (1998). The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 1159–1165.

    Article  PubMed  Google Scholar 

  27. Becker, N., Thomsen, A. B., Olsen, A. K., Sjrogen, P. B., & Eriksen, J. (1997). Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center. Pain, 73, 393–400.

    Article  CAS  PubMed  Google Scholar 

  28. Elliott, A. M., Smith, B. H., Smith, W. C., & Chambers, W. A. (2000). Changes in chronic pain severity over time: The Chronic Pain Grade as a valid measure. Pain, 88, 303–308.

    Article  CAS  PubMed  Google Scholar 

  29. Penny, K. I., Purves, A. M., Smith, B. H., Chambers, W. A., & Smith, W. C. (1999). Relationship between the chronic pain grade and measures of physical, social and psychological well-being. Pain, 79, 275–279.

    Article  CAS  PubMed  Google Scholar 

  30. Tüzün, E. H. (2007). Quality of life in chronic musculoskeletal pain. Best Practice & Research Clinical Rheumatology, 21, 567–579.

    Article  Google Scholar 

Download references

Acknowledgments

We are grateful to Dr Michael Von Korff for his assistance with the use of the Chronic Pain Grade and suggestions for the methodology of this study. ESB Bracher was supported by scholarships from Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazil—CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Brazil—Capes).

Author information

Authors and Affiliations

  1. Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Eduardo S. B. Bracher & José Eluf-Neto

  2. Department of Surgery, Duke University, Durham, NC, USA

    Ricardo Pietrobon

Authors
  1. Eduardo S. B. Bracher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ricardo Pietrobon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. José Eluf-Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo S. B. Bracher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bracher, E.S.B., Pietrobon, R. & Eluf-Neto, J. Cross-cultural adaptation and validation of a Brazilian Portuguese version of the chronic pain grade. Qual Life Res 19, 847–852 (2010). https://doi.org/10.1007/s11136-010-9637-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-010-9637-1

Keywords

Search

Navigation