Psychometric properties of the pain stages of change questionnaire as evaluated by rasch analysis in patients with chronic musculoskeletal pain

BACKGROUND Our objective was to evaluate the measurement properties of the Pain Stages of Change Questionnaire (PSOCQ) and its four subscales Precontemplation, Contemplation, Action and Maintenance. METHODS A total of 231 patients, median age 42 years, with chronic musculoskeletal pain responded to the 30 items in PSOCQ. Thresholds for item scores, and unidimensionality and invariance of the PSOCQ and its four subscales were evaluated by Rasch analysis, partial credit model. RESULTS The items had disordered threshold and needed to be rescored. The 30 items in the PSOCQ did not fit the Rasch model Chi- square item trait statistics. All subscales fitted the Rasch models. The associations to pain (11 point numeric rating scale), emotional distress (Hopkins symptom check list v 25) and self-efficacy (Arthritis Self-Efficacy Scale) were highest for the Precontemplation subscale. CONCLUSION The present analysis revealed that all four subscales in PSOCQ fitted the Rasch model. No common construct for all subscales were identified, but the Action and Maintenance subscales were closely related.