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The Psychological Inflexibility in Pain Scale (PIPS): Validity and Reliability of the Japanese Version for Chronic Low Back Pain and Knee Pain

Authors Nagasawa Y, Shibata A, Fukamachi H, Ishii K, Wicksell RK, Oka K

Received 20 October 2020

Accepted for publication 16 January 2021

Published 4 February 2021 Volume 2021:14 Pages 325—332

DOI https://doi.org/10.2147/JPR.S287549

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa


Yasuhiro Nagasawa,1,2 Ai Shibata,3 Hanako Fukamachi,4,5 Kaori Ishii,5 Rikard K Wicksell,6 Koichiro Oka5

1Department of Rehabilitation, Hasegawa Hospital, Yachimata, Chiba, Japan; 2Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; 3Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 4Sport Sciences Laboratory, Japan Sport Association, Tokyo, Japan; 5Faculty of Sport Sciences, Waseda University, Saitama, Japan; 6Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden

Correspondence: Yasuhiro Nagasawa
Department of Rehabilitation, Hasegawa Hospital, 85 Yachimatani, Yachimata, Chiba, 289-1103, Japan
Tel +81 3 444 0137
Fax +81 3 444 0807
Email nagasawaid@toki.waseda.jp

Purpose: The aim of this study was to translate the Psychological Inflexibility in Pain Scale Japanese version (PIPS-J) and inspect its validity and reliability in older patients with chronic low back pain and knee pain.
Materials and Methods: The PIPS was translated into Japanese by a bilingual linguistic expert and three researchers and administered to 120 outpatients with low back pain and knee pain (61.7% women, age 73.8± 7.8 years). Construct validity and criterion validity were evaluated using confirmatory factor analysis and the correlations with the Acceptance and Action Questionnaire-II Japanese version (AAQ-II-J) and the Cognitive Fusion Questionnaire Japanese version (CFQ-J), respectively. Internal consistency using Cronbach’s alpha and test–retest reliability (n=43) were also examined.
Results: Of all, 78.3% had low back pain, 55.6% had knee pain, and 44.2% both. The confirmatory factor analysis reproduced the original PIPS structure with two factors and indicated good model fit (GFI = 0.915, CFI = 0.970, RMSEA = 0.060). All items’ standardized regression weights ranged from 0.35 to 0.80. Criterion validity was shown by correlations of r = 0.58 for PIPS-J pain avoidance with the AAQ-II-J, and r = 0.45 between PIPS-J cognitive fusion and the CFQ-J. Cronbach’s alpha for the PIPS-J total score was α=0.85 (pain avoidance: 0.87; cognitive fusion: 0.68). The test–retest correlation for all 12 items was r = 0.54 (pain avoidance: 0.48; cognitive fusion: 0.54).
Conclusion: Although a less relevant item was found on each of subscales, the PIPS-J appear to be fairly valid and reliable to evaluate psychological inflexibility in chronic pain among Japanese older adults.

Keywords: pain avoidance, cognitive fusion, older patients, chronic low back pain, chronic knee pain

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