Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue

Deborah Antcliff, Malcolm Campbell, Steve Woby, Philip Keeley

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background. Therapists frequently advise the use of activity pacing as a coping strategy to manage long-term conditions (eg, chronic low back pain, chronic widespread pain, chronic fatigue syndrome/myalgic encephalomyelitis). However, activity pacing has not been clearly operationalized, and there is a paucity of empirical evidence regarding pacing. This paucity of evidence may be partly due to the absence of a widely used pacing scale. To address the limitations of existing pacing scales, the 38-item Activity Pacing Questionnaire (APQ-38) was previously developed using the Delphi technique. Objective. The aims of this study were: (1) to explore the psychometric properties of the APQ-38, (2) to identify underlying pacing themes, and (3) to assess the reliability and validity of the scale. Design. This was a cross-sectional questionnaire study. Methods. Three hundred eleven adult patients with chronic pain or fatigue participated, of whom 69 completed the test-retest analysis. Data obtained for the APQ-38 were analyzed using exploratory factor analysis, internal and test-retest reliability, and validity against 2 existing pacing subscales and validated measures of pain, fatigue, anxiety, depression, avoidance, and mental and physical function. Results. Following factor analysis, 12 items were removed from the APQ-38, and 5 themes of pacing were identified in the resulting 26-item Activity Pacing Questionnaire (APQ-26): activity adjustment, activity consistency, activity progression, activity planning, and activity acceptance. These themes demonstrated satisfactory internal consistency (Cronbach a=.72-.92), test-retest reliability (intraclass correlation coef-ficient=.50-.78, P<.001), and construct validity. Activity adjustment, activity progression, and activity acceptance correlated with worsened symptoms; activity consistency correlated with improved symptoms; and activity planning correlated with both improved and worsened symptoms. Limitations. Data were collected from self-report questionnaires only.Conclusions. Developed to be widely used across a heterogeneous group of patients with chronic pain or fatigue, the APQ-26 is multifaceted and demonstrates reliability and validity. Further study will explore the effects of pacing on patients' symptoms to guide therapists toward advising pacing themes with empirical benefits.

LanguageEnglish
Pages1274-1286
Number of pages13
JournalPhysical Therapy
Volume95
Issue number9
DOIs
Publication statusPublished - 1 Sep 2015
Externally publishedYes

Fingerprint

Psychometrics
Reproducibility of Results
Chronic Pain
Fatigue
Social Adjustment
Chronic Fatigue Syndrome
Statistical Factor Analysis
Delphi Technique
Low Back Pain
Self Report
Anxiety
Cross-Sectional Studies
Surveys and Questionnaires
Depression
Pain

Cite this

Antcliff, Deborah ; Campbell, Malcolm ; Woby, Steve ; Keeley, Philip. / Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue. In: Physical Therapy. 2015 ; Vol. 95, No. 9. pp. 1274-1286.
@article{251248f1e821434696e9dc5565b20164,
title = "Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue",
abstract = "Background. Therapists frequently advise the use of activity pacing as a coping strategy to manage long-term conditions (eg, chronic low back pain, chronic widespread pain, chronic fatigue syndrome/myalgic encephalomyelitis). However, activity pacing has not been clearly operationalized, and there is a paucity of empirical evidence regarding pacing. This paucity of evidence may be partly due to the absence of a widely used pacing scale. To address the limitations of existing pacing scales, the 38-item Activity Pacing Questionnaire (APQ-38) was previously developed using the Delphi technique. Objective. The aims of this study were: (1) to explore the psychometric properties of the APQ-38, (2) to identify underlying pacing themes, and (3) to assess the reliability and validity of the scale. Design. This was a cross-sectional questionnaire study. Methods. Three hundred eleven adult patients with chronic pain or fatigue participated, of whom 69 completed the test-retest analysis. Data obtained for the APQ-38 were analyzed using exploratory factor analysis, internal and test-retest reliability, and validity against 2 existing pacing subscales and validated measures of pain, fatigue, anxiety, depression, avoidance, and mental and physical function. Results. Following factor analysis, 12 items were removed from the APQ-38, and 5 themes of pacing were identified in the resulting 26-item Activity Pacing Questionnaire (APQ-26): activity adjustment, activity consistency, activity progression, activity planning, and activity acceptance. These themes demonstrated satisfactory internal consistency (Cronbach a=.72-.92), test-retest reliability (intraclass correlation coef-ficient=.50-.78, P<.001), and construct validity. Activity adjustment, activity progression, and activity acceptance correlated with worsened symptoms; activity consistency correlated with improved symptoms; and activity planning correlated with both improved and worsened symptoms. Limitations. Data were collected from self-report questionnaires only.Conclusions. Developed to be widely used across a heterogeneous group of patients with chronic pain or fatigue, the APQ-26 is multifaceted and demonstrates reliability and validity. Further study will explore the effects of pacing on patients' symptoms to guide therapists toward advising pacing themes with empirical benefits.",
author = "Deborah Antcliff and Malcolm Campbell and Steve Woby and Philip Keeley",
year = "2015",
month = "9",
day = "1",
doi = "10.2522/ptj.20140405",
language = "English",
volume = "95",
pages = "1274--1286",
journal = "Physical Therapy",
issn = "0031-9023",
publisher = "American Physical Therapy Association",
number = "9",

}

Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue. / Antcliff, Deborah; Campbell, Malcolm; Woby, Steve; Keeley, Philip.

In: Physical Therapy, Vol. 95, No. 9, 01.09.2015, p. 1274-1286.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Assessing the psychometric properties of an activity pacing questionnaire for chronic pain and fatigue

AU - Antcliff, Deborah

AU - Campbell, Malcolm

AU - Woby, Steve

AU - Keeley, Philip

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background. Therapists frequently advise the use of activity pacing as a coping strategy to manage long-term conditions (eg, chronic low back pain, chronic widespread pain, chronic fatigue syndrome/myalgic encephalomyelitis). However, activity pacing has not been clearly operationalized, and there is a paucity of empirical evidence regarding pacing. This paucity of evidence may be partly due to the absence of a widely used pacing scale. To address the limitations of existing pacing scales, the 38-item Activity Pacing Questionnaire (APQ-38) was previously developed using the Delphi technique. Objective. The aims of this study were: (1) to explore the psychometric properties of the APQ-38, (2) to identify underlying pacing themes, and (3) to assess the reliability and validity of the scale. Design. This was a cross-sectional questionnaire study. Methods. Three hundred eleven adult patients with chronic pain or fatigue participated, of whom 69 completed the test-retest analysis. Data obtained for the APQ-38 were analyzed using exploratory factor analysis, internal and test-retest reliability, and validity against 2 existing pacing subscales and validated measures of pain, fatigue, anxiety, depression, avoidance, and mental and physical function. Results. Following factor analysis, 12 items were removed from the APQ-38, and 5 themes of pacing were identified in the resulting 26-item Activity Pacing Questionnaire (APQ-26): activity adjustment, activity consistency, activity progression, activity planning, and activity acceptance. These themes demonstrated satisfactory internal consistency (Cronbach a=.72-.92), test-retest reliability (intraclass correlation coef-ficient=.50-.78, P<.001), and construct validity. Activity adjustment, activity progression, and activity acceptance correlated with worsened symptoms; activity consistency correlated with improved symptoms; and activity planning correlated with both improved and worsened symptoms. Limitations. Data were collected from self-report questionnaires only.Conclusions. Developed to be widely used across a heterogeneous group of patients with chronic pain or fatigue, the APQ-26 is multifaceted and demonstrates reliability and validity. Further study will explore the effects of pacing on patients' symptoms to guide therapists toward advising pacing themes with empirical benefits.

AB - Background. Therapists frequently advise the use of activity pacing as a coping strategy to manage long-term conditions (eg, chronic low back pain, chronic widespread pain, chronic fatigue syndrome/myalgic encephalomyelitis). However, activity pacing has not been clearly operationalized, and there is a paucity of empirical evidence regarding pacing. This paucity of evidence may be partly due to the absence of a widely used pacing scale. To address the limitations of existing pacing scales, the 38-item Activity Pacing Questionnaire (APQ-38) was previously developed using the Delphi technique. Objective. The aims of this study were: (1) to explore the psychometric properties of the APQ-38, (2) to identify underlying pacing themes, and (3) to assess the reliability and validity of the scale. Design. This was a cross-sectional questionnaire study. Methods. Three hundred eleven adult patients with chronic pain or fatigue participated, of whom 69 completed the test-retest analysis. Data obtained for the APQ-38 were analyzed using exploratory factor analysis, internal and test-retest reliability, and validity against 2 existing pacing subscales and validated measures of pain, fatigue, anxiety, depression, avoidance, and mental and physical function. Results. Following factor analysis, 12 items were removed from the APQ-38, and 5 themes of pacing were identified in the resulting 26-item Activity Pacing Questionnaire (APQ-26): activity adjustment, activity consistency, activity progression, activity planning, and activity acceptance. These themes demonstrated satisfactory internal consistency (Cronbach a=.72-.92), test-retest reliability (intraclass correlation coef-ficient=.50-.78, P<.001), and construct validity. Activity adjustment, activity progression, and activity acceptance correlated with worsened symptoms; activity consistency correlated with improved symptoms; and activity planning correlated with both improved and worsened symptoms. Limitations. Data were collected from self-report questionnaires only.Conclusions. Developed to be widely used across a heterogeneous group of patients with chronic pain or fatigue, the APQ-26 is multifaceted and demonstrates reliability and validity. Further study will explore the effects of pacing on patients' symptoms to guide therapists toward advising pacing themes with empirical benefits.

UR - http://www.scopus.com/inward/record.url?scp=84940763674&partnerID=8YFLogxK

U2 - 10.2522/ptj.20140405

DO - 10.2522/ptj.20140405

M3 - Article

VL - 95

SP - 1274

EP - 1286

JO - Physical Therapy

T2 - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 9

ER -