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Validation Studies for the Labor Pain Questionnaire: Comparison with the SF-1 and POM
Abstract Number: S-68
Abstract Type: Original Research
Introduction: The Short form 1 (SF-1 MPQ) version of the Long form McGill Pain Questionnaire (L-MPQ) and the Pain-O-meter(POM) are multidimensional tools that have been used for pain measurement during childbirth. Descriptors on both tools may be traced to the L-MPQ. Despite its use in obstetrics, the L-MPQ was not intended for pain measurement during childbirth and contains pain descriptors derived largely from the experiences of men. A health specific instrument, developed specifically for measurement of childbirth pain is likely to provide a more valid reflection of women’s pain during childbirth. We report findings from validation studies which compared performance of two newly derived versions of a 22-item Labor Pain Questionnaire (LPQ) with the SF-1 MPQ and the POM using the parturient responses in the LPQ derivation sample.
Methods: With REB approval, underlying dimensions of women’s childbirth pain experiences were compared between two versions of the LPQ (derived using Principal Components Analysis, Exploratory factor analysis followed by Varimax rotation or PAF with Promax rotation), SF-1MPQ and the POM using responses from 433 parturients in the database from which the LPQ was derived and the same statistical techniques. The interpretability of solutions as well as the internal consistency reliability associated with each scale and subscale was also examined and compared with LPQ versions.
Results: Five theoretically and clinically meaningful dimensions of the childbirth pain experience were found using the LPQ. These were: The Enormity of the Pain, Fear and Anxiety, Uterine Contraction Pain, Vaginal “Birthing Pain”, and Back pain /Long Haul. Internal consistency reliabilities for both versions of the LPQ were also good or better for all subscales (0715 to 0.864) and the entire 22 item tool (0.894, 0.895) In contrast, items found on the SF-1 MPQ suggested that 4 dimensions underpin the experience of childbirth pain and the first (and most important) Factor for the LPQ, The Enormity of the Pain, was entirely omitted. Residual variance in the solution also suggested that another underlying factor remained unextracted in the data. Internal consistency reliability for the Birthing/delivery subscale equivalent for the SF-1 was also inadequate (Cronbach’s alpha 0.686). Assessment of the underlying factor structure of the POM suggested that women’s experiences of childbirth pain consisted of 6 dimensions. While the 26 questions found on this tool predictably increased internal consistency reliability (Cronbach’s alpha 0.902), one dimension (Fear and Anxiety) was entirely missing and two others were not easily interpreted. The sixth dimension was difficult to interpret and possessed very low (0.361 ) internal consistency reliability.
Discussion: Findings from comparison of both versions of the LPQ with the SF-1 MPQ and the POM suggests that LPQ performance is superior to the other 2 tools.