Development and validation of the partner acceptance scale for chronic pain (PAS-CP)
University of New Brunswick
Background: Chronic pain has a significant impact on patients and their romantic partners. The benefits of chronic pain acceptance for patients are well-established; however, partner chronic pain acceptance has been under researched. One recent study identified five themes thought to characterize partner pain acceptance, but no theoretically and psychometrically sound measure of the construct currently exists. Objective: To address this gap in the literature, the current project aimed to develop and validate a new self-report measure, the Partner Acceptance Scale for Chronic Pain (PAS-CP). Method: In Study 1, the PAS-CP item pool was generated, reviewed by five acceptance experts (Part A), and pilot tested on nine partners (Part B). In Study 2, 217 adult partners (48.8% male) completed the PAS-CP and measures of depression, anxiety, stress, relationship satisfaction, and experiential acceptance via an online survey. The item pool was then submitted to an exploratory factor analysis (EFA) and preliminary psychometric properties of the PAS-CP were evaluated. Results: In Study 1, chronic pain acceptance experts and partners provided feedback that was used to revise existing PAS-CP items (e.g., improve clarity and conciseness), create new items (e.g., to capture different aspects of acceptance), and improve the scale's response options. In Study 2, EFA resulted in the creation of the PAS-CP-13, a 13-item measure with two factors, good reliability, and modest concurrent and convergent validity; however, examination of the PAS-CP-13 factors revealed it did not adequately measure the full scope of the acceptance construct, but rather measured partners' engagement in values-driven action regardless of the patient's chronic pain and partners' understanding of the chronicity of their spouse's chronic pain. This finding suggests the PAS-CP-13 has inadequate content validity. Conclusions: Although the PAS-CP-13 is not yet suitable for use in research and clinical practice, the current dissertation contributed to the advancement of partner pain acceptance conceptualization and highlighted a number of improvements that can be made to future scale development efforts. Clinically, these findings confirm a proportion of partners experience clinically significant psychological distress and/or low relationship satisfaction and may be in need of psychotherapy to help them adjust to their spouse's chronic pain.