Factor structure and psychometric properties of the Chinese version of the 20-item Pain Anxiety Symptoms Scale (ChPASS-20).
BACKGROUND
The Pain Anxiety Symptoms Scale (PASS) was designed to assess pain-related anxiety and fear. Although the scale is a reliable measure with good psychometric properties, its validity among ethnic Chinese has yet to be evaluated.


OBJECTIVE
This study aimed to translate the English-language version of the 20-item PASS into Chinese (ChPASS-20) and evaluate its factor structure, reliability, and validity.


METHODS
A total of 223 Chinese patients with chronic musculoskeletal pain attending orthopedic specialist clinics completed the ChPASS-20, the Chronic Pain Grade questionnaire, the Chinese version of the 11-item Tampa Scale of Kinesiophobia, the Hospital Anxiety and Depression Scale, and questions assessing sociodemographic and pain characteristics.


RESULTS
Confirmatory factor analyses showed that all the five-factor solutions tested met the minimum acceptable fit criterion. The four ChPASS-20 subscales and the entire scale demonstrated good internal consistency (Cronbach's αs: 0.72-0.92). All ChPASS-20 scales showed significant positive correlations with depression, pain intensity, and disability. Hierarchical multiple regression analyses showed that the ChPASS-20 total score predicted concurrent depression [F(4,159)=11.97, P<0.001], pain intensity [F(4,161)=2.47, P<0.05], and pain disability [F(4,191)=5.47, P<0.001] scores, and the ChPASS-20 Avoidance subscale (standardized beta coefficient=0.21, P<0.05) emerged as a significant independent predictor of concurrent pain disability.


CONCLUSIONS
Our data support the factorial validity, reliability, and construct validity of the ChPASS-20 in a Chinese population.
Department of Psychological Studies, The Hong Kong Institute of Education, Tai Po, Hong Kong. wingwong@ied.edu.hk
Wing S
WS
Wong
Lance M
LM
McCracken
Richard
R
Fielding
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D015995:Prevalence; D011594:Psychometrics / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult