Validation of Total Pain Questionnaire in Post Spinal Surgery Syndrome
Dr Biplab Sarkar*¶, Dr Bahni Aich*, Dr Gargi Nandi*, Dr Subrata Goswami*
*ESI Institute of Pain Management, ¶Bankura Sammilani Medical College, India
ID-1024312
Contact information: Mob: +91 9432955596, E mail: biplab108cmc@gmail.com
Introduction
✓ Post spinal surgery syndrome, also known as Failed
Back Surgery Syndrome (FBSS)
✓ defined as lumbar spinal pain either persisting
despite surgical intervention or appearing after
surgical intervention for spinal pain originally in the
same topographical distribution.
✓ 10-40% patients after spinal surgeries suffers from
this chronic debilitating
pain condition often associated
with depression, frustration,
economical loss, loss in faith
and poor quality of life.
✓ A total pain questionnaire
refers to multidimensional
nature of pain.
✓ In a busy overburdened
Government Pain Clinic
from Eastern India, it is very
difficult to measure the
magnitude of total pain with
proper emphasis on all these aspects.
✓ A short questionnaire is needed which can be
administered in a very short period of time.
✓ More than 60% of the patients coming to our pain
clinic prefer Hindi language for communication.
✓ Use of hindi version of PEG questionnaire (Pain
average, interference with Enjoyment of life and
interference with General activity), which is an
ultra-short version of Brief Pain Inventory (BPI)
Questionnaire in patients with post spinal surgery
syndrome, could not been found in literature.
Aim of the study
✓ To validate translated Hindi version of PEG
questionnaire in patients with post spinal surgery
syndrome.
Methodology
✓ Institutional ethics committee approval
✓ Permission to use the BPI and PEG questionnaire
obtained from appropriate authority.
✓ 30 Hindi speaking adult patients with post spinal
surgery patients were included in the study with
informed written consent form each patient.
✓ Patients with severe spinal cord stenosis, motor
weakness, major psychiatric co morbidity, history of
drug abuse, and malignancy were excluded from the
study.
❖ Study
flow
chart:
❖ After pretesting, the translated Hindi
version of PEG was validated against
BPI in 30 patients with Post spinal surgery syndrome
Result & Discussion
✓ Internal consistency of the Hindi PEG
questionnaire was 0.77 as determined by
Cronbach’s alpha and showed good reliability.
✓ In Test Retest reliability assessment, intra-class
co-relation for stability assessment of Hindi PEG
was found to be satisfactory for each component
as well as in total PEG value (p<0.001).
✓ The construct validity of the Hindi PEG
questionnaire was good with both Hindi BPI Pain
intensity and BPI pain interference scale.
✓ The Pearson Correlation Coefficient was higher in
case of BPI pain intensity (r= 0.92) than BPI pain
interference (r=0.75).
Conclusion
✓ Hindi version of PEG is valid and reliable to assess
total pain in post spinal surgery syndrome.
✓ As it is very short, it may be practically useful in
busy out patients and inpatient settings.
Limitation:
✓ Spiritual aspects of total pain can not be measured by
PEG questionnaire and further large scale cohort studies
are required prior using it in day to day practice.
❖ Conflict of interest: NIL ❖ Funding: NIL
References:
1.Krebs, Erin E et al. “Development and initial validation of the
PEG, a three-item scale assessing pain intensity and
interference.” J Gen Intern Medi vol. 24,6 (2009): 733-8.
2.Saxena A et al. The assessment of cancer pain in north India:
the validation of the Hindi Brief Pain Inventory--BPI-H. J Pain
Symptom Manage. 1999;17(1):27-41.