Chronic Pain Coping Inventory (CPCI)

The CPCI originally contained eight subscales consisting of 64 items designed to measure pain coping strategies, and an additional item that asks the patient to list current medications and the number of days per week that it is used. The researchers conceptualized subscales for the coping strategies as being encouraged or wellness-focused [(1) Coping Self Statements, (2) Relaxation, (3) Task Persistence, (4) Exercise/Stretching], discouraged or illness-focused [(5) Guarding, (6) Resting, (7) Asking for Assistance, Medication use], and neither/neutral [(8) Seeking Social Support]. (Ref: 1-3,7) A six-item pacing subscale was later developed and is now included in the CPCI. (Ref: 6) There is a 51-item (+ medications) Significant Other (SO) questionnaire that includes items tapping all subscales except “Coping Self Statements”. (Ref: 2)

Free; available in developmental article Appendix and the user manual. (Ref: 1-2) Please

No information found. Based on the number of items, it is estimated at 30 minutes.

1995

Items are on average 15 words or less. Sentences are simple and vocabulary seems appropriate for the target audience. The most technical term is “self-hypnosis,” while the most difficult term among items is “distracting.”

The CPCI has an eight-point scale (0 to 7) representing the number of days in the past week that a patient used a specific coping strategy. (Ref: 1)

Self-administered

All items responded to (not including medication use) are summed and divided by the total number of items responded to. To score medication use (item 65), categorize each medication that the patient reported using for pain in the last week as opiods, sedative-hypnotics, and non-steroidal anti-inflammatory medications (NSAID). Any opoid or sedative should be grouped as “opiod and/or sedative,” and any NSAID not containing an opiod or sedative should be grouped as an NSAID. Sum the total number of days each medication category was used; this number may be greater than seven. Subscales are scored by summing the items included in each scale and dividing by the number of items. (Ref: 1)

Swedish version. (Ref: Ektor-Anderson J, Orbaek P, Isacsson SO, J of Rehab Med. 2002;34: 33-9) Significant-other version. (Ref: 1-2) One- and two-item versions. (Ref: 8)

Mark P. Jensen, Judith A. Turner, Joan M. Romano, Susan E. Strom

University of Washington School of Medicine
Seattle, WA 98195

mjensen@u.washington.edu

depts.washington.edu/rehab/contacts/jensen.html

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Principal components factor analysis with oblique rotation was performed. A seven-factor solution was found, which accounted for 48.94% of the variance. There were a number of items that cross-loaded on several factors, therefore, further factor analysis was performed and an eight-factor solution was found. This accounted for 51.53% of the variance, and only six of the items loaded >=0.30 on more than one factor. The final factor structure was: 1) Coping Self Statements, 2) Guarding of Walking/Standing, 3) Exercising/Stretching, 4) Task Persistence, 5) Seeking Social Support, 6) Asking for Assistance, 7) Resting, and 8) Relaxation. Correlations among the final 8 factors were small, ranging from 0.00 to 0.29. (Ref: 3)

Although normative information was not found, means and standard deviations were provided for a sample of 50 adults with cerebral palsy and chronic pain: (Ref: 5)

Test-retest for the original eight scales and three medication measures ranged from 0.70 to 0.90, except for the Non-steroidal Medication Use measure, which was r=0.66. The time interval for this retest was two weeks. (Ref: 1) Test-retest (p<0.001), over an average of 12.60 weeks, was performed using the CPCI with the pacing subscale included. Results follow: (Ref: 6)

No information found.

In the developmental study, alpha coefficients for the initial eight scales (57 items) ranged from 0.70 to 0.93. During the validation phase of this study, alpha ranged from 0.74 to 0.91 for the 65-item CPCI. A version created for significant others, consisting of seven scales, produced an alpha range of 0.75 to 0.87. (Ref: 1) The reliability of the most recent addition to the CPCI, the pacing subscale, was assessed as well. It showed inter-item correlations from 0.55 to 0.74, item-total correlations from 0.71 to 0.79, and a Cronbach’s alpha of 0.91. (Ref: 6)

No information found.

In the developmental sample of 176 chronic pain patients, the CPCI (57 items) was correlated with the Center for Epidemiological Studies Depression Scale (CES-D), Pain Discomfort Scale (PDS), and Multidimensional Pain Inventory-Activity Scale (MPI-A). Significant (p<0.001) correlations were reported as follows: (Ref: 1)

A series of hierarchical regressions was performed to determine the relationship between the CPCI scales, CSQ scales, and depression and disability. Age, education, gender, and pain severity were controlled for. The model, including the control variables and the CPCI scales alone, accounted for 18.3% of the variance in depression. After controlling for demographic variables, pain severity, and the CSQ scales, the CPCI accounted for 20.7% of the variance in disability. (Ref: 7)

Three of the developmental authors constructed a list of pain coping strategies based on strategies used in the University of Washington Multidisciplinary Pain Treatment Program and strategies found in pain and coping literature reviews. The authors prepared a paragraph description of each strategy, which was then used to create items. An item-writing strategy that included interviews with chronic pain patients would better support the content validity of the scale. Nevertheless, the approach used was disciplined and based on a clear definition of coping, and the method supports the content validity of the instrument. Selection of item content for the subscales also supported the content validity of the instrument. Items were retained if they met both of two criteria: (1) estimated correlation with the parent scale at least 0.40 and (2) estimated correlation at least 0.15 greater than the correlation between the item and all other scales. (Ref: 1)

CPCI subscales appeared responsive to change in coping skills resulting from coping skills training. Full subscales were reported to be more sensitive than their reduced (2-item and 1-item) versions. (Ref: 8)

Yes. (Ref: 7)

Yes. (Ref: 1,3-6,8)