• Mark P Jensen, Chen-Ping Lin, Amy E Kupper, Bradley S Galer, and Arnold R Gammaitoni.
• Department of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA. mjensen@uw.edu
• Clin J Pain. 2013 May 1;29(5):400-10.

ObjectiveTo revise the Pain Quality Assessment Scale (PQAS) using feedback from patients to further increase its validity.MethodsThis project involved 3 cognitive interviewing studies. In Study 1, a group of patients with chronic pain (N=20) were asked a series of questions regarding the PQAS's understandability, and invited to make suggestions regarding how the measure could be improved. In Study 2, a second group of patients (N=21) responded to questions about a modified version of the PQAS. The PQAS was further modified on the basis of the findings of Study 2, and in Study 3 the participants were asked to indicate whether the changes made improved the understandability of the PQAS further.ResultsThe participants in Studies 1 and 2 identified portions of the PQAS instructions and some of the PQAS items that could be modified to increase their understandability. Modifications resulted in a revised PQAS that was deemed by patients with chronic pain to be more understandable than the original PQAS by the majority of participants.Discussiontesting can be used to improve the understandability of pain measures. The results of cognitive testing with the PQAS indicated that much of the content of the original instructions and items were understandable as written, but that minor changes could be made to make them even clearer to patients with chronic pain. The changes made resulted in a revised PQAS that is more understandable and may therefore be even more useful than with the original PQAS.

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