title: Measuring pain in the context of homelessness.
abstract: OBJECTIVE
  The primary objective of this study was to inform the development of measures of pain impact appropriate for all respondents, including homeless individuals, so that they can be used in clinical research and practice. The secondary objective was to increase understanding about the unique experience of homeless people with pain.
  
  
  METHODS
  Seventeen homeless individuals with chronic health conditions (often associated with pain) participated in cognitive interviews to test the functioning of 56 pain measurement items and provided information about their experience living with and accessing treatment for pain.
  
  
  RESULTS
  The most common problems identified with items were that they lacked clarity or were irrelevant in the context of homelessness. Items that were unclear, irrelevant and/or had other identified problems made it difficult for participants to respond. Participants also described multiple ways in which their pain was exacerbated by conditions of homelessness and identified barriers to accessing appropriate treatment.
  
  
  CONCLUSIONS
  Results suggested that the majority of items were problematic for the homeless and require substantial modifications to make the pain impact bank relevant to this population. Additional recommendations include involving homeless in future item bank development, conducting research on the topic of pain and homelessness, and using cognitive interviewing in other types of health disparities research.
authors: Center for Technology and Disability Studies, University of Washington, Seattle, WA 98195-7920, USA. bmatter@u.washington.edu
authors: Rebecca
authors: R
authors: Matter
authors: Susan
authors: S
authors: Kline
authors: Karon F
authors: KF
authors: Cook
authors: Dagmar
authors: D
authors: Amtmann
mesh_terms: D002908:Chronic Disease; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*