Spanish translation and preliminary validation of the Pain Treatment Satisfaction Scale

Introduction

Satisfactory pain management is important to prevent adverse physical and psychological results for patients and their families. Through the activation of the pituitary-adrenal axis, inadequate pain treatment could produce postsurgical infection and poor wound healing. Pain also actives the sympathetic nervous system, which results in disruption of the cardiovascular, gastrointestinal and renal systems¹. In addition, patients with pain may have a sense of helplessness or hopelessness. This may predispose them to anxiety and depression, and they may be reluctant to seek medical care for other health problems².

Adequate pain control can improve the patient’s attitudes and behaviors toward their treatment. They are more willing to comply with the advice of their health care provider, miss fewer medical appointments and are more likely to adhere to their medical treatment³. In this sense, surveys to measure patient satisfaction and pain treatment are important for adequate health care. The aim of this study was to translate the Pain Treatment Satisfaction Scale (PTSS)⁴ into Spanish and analyze some of its psychometric properties.

Methods

Survey. The PTSS was developed by Evans et al.⁴ and validated to assess satisfaction in patients with both acute and chronic pain. This survey includes 39 items grouped into five dimensions: information about your pain and treatment (5 items); medical care (8 items); impact of current pain medication (8 items); satisfaction with pain medication, which included the two subscales medication characteristics (3 items) and efficacy (3 items); and side effects (12 items). Each item is measured with a 5 point-Likert scale which ranges from 1 (major satisfaction) to 5 (worst satisfaction). Scales and items were transformed to a 0 to 100 score, where 100 represents highest satisfaction.

Translation. This process was carried out in 4 steps. In the first step, 2 authors, experts in pain medicine (TANO and SCG), performed the translation from English to Spanish. In the second step, all authors reviewed the translation and gave suggestions and recommendations to improve the clarity of the items. In the third step, external professional translators made the inverse translation from Spanish to English. In the final step, all authors reviewed both the inverse translation and the original survey.

Sample. We applied the Spanish version to a random sample of 174 patients from the Dr José E. Gonzalez University Hospital with some type of pain. They were interviewed in the postoperative or ambulatory areas. Patients older than 18 years who gave verbal consent were included in this study. The Ethical Committee of the Faculty of Medicine of the Autonomous University of Nuevo León approved this study, and exempted from written informed consent. The reference number is AN15-004.

Statistical analysis. Results of each dimension were calculate. Reliability was measured with Chronbach´s alpha test. The criterion of acceptability was 0.7. The construct validity, which included convergent and divergent validity, was evaluated with a multitrait-multimethod analysis. Convergent validity and divergent validity were expressed as %successful. Convergent validity was calculated with the following formula %successful = [(correlations “item–dimension to which it belongs >0.4”)/(total correlations “item–dimension to which it belongs”)]*100. The formula for divergent validity was %successful = [(number of correlations item – dimension lesser that correlations item-dimension to which it belongs)/(total correlations item-dimension to which it does not belong)]*100. Correlations were obtained with the matrix multitrait-multimethod. The statistical software SPSS 21 and the package Psy for R 3.2.2 were used for the analyses.

Results