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The Coping Strategies Questionnaire (CSQ) was developed, refined, and decreased from the original 50-item questionnaire to a more ‘user-friendly’ 14-item version. Chronic pain and coping. Pain-free or experiencing much less pain. Coping Styles Questionnaires - Free PDF downloads. Www.parqol.com/page.cfm?id=127 Coping Strategies Questionnaire (CSQ) Description: A measure of coping with pain [1]. Format: The CSQ consists of 6 cognitive (diverting attention, reinterpreting.

  1. The Coping Strategies Questionnaire (CSQ) was developed, refined, and decreased from the original 50-item questionnaire to a more ‘user-friendly’ 14-item version. Chronic pain and coping. Pain-free or experiencing much less pain. Coping Styles Questionnaires - Free PDF downloads.
  2. Chronic pain is one of most frequently occurring symptoms in various diseases, also the oncological disease. The aim of the study was to evaluate the strategies used to cope with pain, depending on the location of pain control, taking into account the subjective assessment of pain. The study used: BPCQ – The Beliefs about Pain Control Questionnaire, CSQ – The Pain Coping Strategies.

Free Online Library: The coping strategy questionnaire.(Appraisal: Critically Appraised Papers, Report) by 'Australian Journal of Physiotherapy'; Health, general Back pain Analysis Surveys Backache Life skills Management Osteoarthritis Care and treatment Patient outcomes Pain Methods Pain management Questionnaires Usage Rheumatoid factor. The present study has examined coping strategies in two distinctly different groups of chronic pain patients and a group of healthy controls. Thirty neuropathic pain (NP) patients, 28 fibromyalgia (FM) patients, and 26 pain‐free healthy controls completed the Coping Strategy Questionnaire (CSQ‐48/27) and rated their daily pain.

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Abstract

BACKGROUND:

Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain.

OBJECTIVE:

To develop an Italian version of the Coping Strategies Questionnaire – Revised (CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain.

METHODS:

The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach’s alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile – Roland Scale), depression (Center for Epidemiological Studies – Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson’s correlation).

RESULTS:

Confirmatory factor analysis revealed that the CSQ-R model had an acceptable rules='groups'>Characteristicn (%)Marital status Unmarried156 (45.2) Married189 (54.8)Occupation Employee120 (34.8) Self-employed88 (25.5) Housewife47 (13.6) Pensioner90 (26.1)Education Primary school46 (13.3) Middle school102 (29.6) High school138 (40.0) University59 (17.1)Smoking Yes112 (32.5) No233 (67.5)Pain sites (principal) Cervical67 (19.4) Lumbar135 (39.1) Shoulder34 (9.9) Hip28 (8.1) Knee56 (16.2) Other25 (7.2)Drug use Antidepressants59 (17.1) Analgesics152 (44.1) Muscle relaxants37 (10.7) Nonsteroidal anti-inflammatory drugs97 (28.1)Comorbidities (principal) Hypertension111 (32.2) Non-insulin-dependant diabetes mellitus44 (12.8) Heart disease49 (14.2) Enteric disease38 (11.0) Liver disease33 (9.6) None70 (20.3)

The clinical and sociodemographic findings are largely consistent with those found by the original developers of the CSQ-Revised, being representative of subjects with chronic pain (6,7).

Translation and cross-cultural adaptation

The questionnaire was translated into Italian using a process of forward-backward translation involving four translators. It took two months to reach a culturally adapted version; all of the items were easily translated except two questions (“I try to feel distant from the pain almost as if the pain was in somebody else’s body” and “I try not to think of it as my body, but rather as something separate from me”), but these difficulties were overcome by means of careful wording. A further review by experts and the testing of the penultimate version confirmed the correctness of the process of translation/back-translation and the content of the items.

The adapted questionnaire is reproduced in Appendix 1.

Analytical scale properties

Acceptability:

All of the questions were well accepted. The CSQ-Revised was completed in 11.1±1.5 min, and there were no missing or multiple answers. There were no problems with regard to comprehension.

Factor analysis:

CFA met all of the fit criteria confirming the model on the present sample (Table 2) (7). The item-scale correlations were satisfactory (Distraction, 0.751 to 0.913; Catastrophizing, 0.849 to 0.891; Ignoring pain sensations, 0.821 to 0.957; Distancing from pain, 0.925 to 0.932; Coping self-statements, 0.829 to 0.926; and Praying, 0.781 to 0.982).

TABLE 2

Results of confirmatory factor analysis of the factorial validity of the Coping Strategies Questionnaire – Revised

Modelχ2/dfCFINFIRMSEA90% CI of RMSEA
Robinson et al (7)2.970.9360.9080.0780.072–0.083

χ2/df Ratio between χ2 and df; CFI Comparative fit index; NFI Normed-fit index; RMSEA Root-mean square error of approximation

Floor/ceiling effects:

No significant effects were found for any of the subscales (Table 3).

TABLE 3

Floor/ceiling effects and reliability of the Coping Strategies Questionnaire – Revised subscales

Coping Strategies Questionnaire Csq

Variables and subscalesMean ± SDFloor/ceiling effects, %/%Internal consistency, αTest-retest, ICC (95% CI)
Distraction (5 items)16.29±7.223.8/3.20.9340.904 (0.853–0.939)
Catastrophizing (6 items)16.85±9.787.8/0.90.9460.918 (0.873–0.947)
Ignoring pain sensations (5 items)14.21±8.376.7/5.80.9570.899 (0.853–0.931)
Distancing from pain (4 items)9.38±6.367.0/2.60.9610.911 (0.863–0.943)
Coping self-statements (4 items)16.22±5.513.2/11.00.9280.850 (0.785–0.897)
Praying (3 items)11.78±4.896.4/12.80.9140.851 (0.768–0.906)

Reliability:

Cronbach’s alpha was acceptable for all of the subscales (α=0.914 to 0.961). Test-retest reliability was measured in all of the subjects, and the domains showed good/excellent intraclass correlation coefficients (0.850 to 0.918) (Table 3).

Content validity:

The percentage of affirmative answers was >90% and, thus, the content of the items was considered to be adequate, appropriate for the target population, comprehensive and relevant for investigating coping strategies in this population.

Construct validity:

Most of the a priori hypotheses were confirmed. As expected, Catastrophizing (from r=0.27 to r=0.49) and Praying (from r=0.14 to r=0.23) were statistically significantly and positively related to other similar constructs. Catastrophizing was moderately correlated with Depression (r=0.49; P<0.01) (Table 4).

TABLE 4

Correlations between the Coping Strategies Questionnaire – Revised (CSQ-R) subscales and pain, disability and depression

Variables and subscalesPain (NRS)Disability (SIP-Roland)Depression (CES-D)
CSQ-R
Distraction (5 items)−0.060.08−0.18*
Catastrophising (6 items)0.27**0.36**0.49**
Ignoring pain sensations (5 items)0.07−0.12−0.19**
Distancing from pain (4 items)0.110.11−0.18**
Coping self-statements (4 items)0.01−0.08−0.33**
Praying (3 items)0.14*0.23**0.15*

CES-D Center for Epidemiological Studies – Depression Scale; NRS Numerical rating scale; SIP-Roland Sickness Impact Profile –Roland Scale

When the coping questionnaires were compared, Catastrophizing and Praying were statistically significantly and positively related to CPCI maladaptive strategies (from r=0.11 to r=0.26, and from r=0.17 to r=0.29); weaker correlations were found in the case of adaptive strategies, except when CPCI Seeking social support was compared with Catastrophizing (r=0.14) and Praying (r=0.26). Likewise, Distraction, Distancing from pain and Coping self-statements were statistically significantly and positively related to CPCI adaptive strategies (from r=0.25 to r=0.50, from r=0.23 to r=0.43, and from r=0.13 to r=0.54) (Table 5).

TABLE 5

Correlations between the Coping Strategies Questionnaire – Revised and Chronic Pain Coping Inventory (CPCI) subscales

CPCI subscalesCoping Strategies Questionnaire – Revised subscales
DistractionCatastrophizingIgnoring pain sensationsDistancing from painCoping self-statementsPraying
Guarding0.21**0.18**−0.22**0.02−0.050.29**
Resting0.110.11−0.14*−0.09−0.040.17**
Asking for assistance0.090.26**−0.21**−0.06−0.090.28**
Relaxation0.50**0.030.060.43**0.35**0.05
Task persistence0.26**−0.20**0.55**0.43**0.46**−0.25**
Exercise/stretch0.25**0.010.090.23**0.13*0.05
Seeking social support0.35**0.14*0.060.23**0.30**0.26**
Coping self-statements0.48**−0.100.23**0.33**0.54**0.07
**P<0.01.

DISCUSSION

The present study reports the adaptation of the CSQ-Revised and its validation in a sample of previously uninvestigated Italian patients with chronic pain. Analyzing the psychometric properties of an outcome measure is a continuous process that is strongly recommended to strengthen its properties and expand its applicability to specific populations and contexts (24). Our findings provide further evidence regarding the relationships between CSQ-Revised and CPCI, two widely used questionnaires that assess coping strategies in individuals with chronic pain.

Coping strategy questionnaire pdf

The meaning of the original items was adequately captured by the idiomatic translation of the CSQ-Revised. The difficulties encountered by the translators were overcome by means of careful wording. The questionnaire was acceptable and easily understood, and could be self-administered in approximately 10 min. It responded satisfactorily to the requirements of relevance and completeness, and appeared to be fully applicable to everyday clinical practice. No significant floor/ ceiling effects were found, which suggests the scale correctly assesses its construct.

The factorial structure of the CSQ-Revised was confirmed, and the satisfactory item-scale correlations enabled us to include all of the 27 items, as originally proposed (7). This model adequately fits the data obtained from our sample, which suggests that coping strategies can be thoroughly described as a process with six components. French researchers have also performed a CFA using the CSQ-Revised, and achieved satisfactory results consistent with our findings and those of Riley and Robinson (8,9).

Our internal consistency was satisfactory, thus confirming the extent to which the items assessed the same construct. Our estimates were higher than that of the developers of the CSQ-Revised (α=0.72 to 0.86) and the French adaptation (α=0.57 to 0.83) (7,9).

The CSQ-Revised also showed satisfactory test-retest reliability in the investigated population and context; however, this psychometric property was not tested in the original and other adapted versions of the CSQ-Revised and, thus, no comparisons are possible.

Consistent with the English findings (8), our estimates of construct validity highlighted the adaptive (ie, Distraction, Ignoring pain sensations, Distancing from pain and Coping self-statements) and maladaptive properties (Catastrophizing and Praying) of most of the subscales (4,7,25).

The correlations between the CSQ-Revised and the CPCI contributed further evidence of the adaptive and maladaptive strategies investigated by both measures. Our findings also suggest that the CSQ-Revised and CPCI have different constructs, thus highlighting their distinctive contribution to multidisciplinary pain programs and confirming the intent of the original developers of the CPCI to create a questionnaire that investigated previously ignored coping strategies (22). As observed in previous studies (26), exceptions were the correlations between CPCI-Task persistence and CSQ-Ignoring pain sensations, CSQ-Distancing from pain and CSQ-Coping self-statements; between CPCI-Relaxation and CSQ-Distraction and CSQ-Distancing from pain; and between CPCI-Coping self-statements and CSQ-Distraction and CSQ-Coping self-statements, which suggests that these constructs likely overlap in scale content and require further investigations.

There were several limitations to the present study. First, its cross-sectional design means that significant correlations should not be confused with causal effects. Second, the relationships between self-reported beliefs and objective measures of coping, such as behavioural observations or reports of cognitive coping during structured or standardized situations, were not considered because only self-administered measures were used. Third, additional studies of the properties of CSQ-Revised using modern test theory methods, such as Rasch measurement theory or item response theory, are recommended because only classical test theory psychometric properties were evaluated.

CONCLUSION

The Italian version of the CSQ-Revised confirmed the factor structure of the original English version and showed good psychometric properties. It can be recommended for use in chronic pain research and multidisciplinary pain assessments.

Acknowledgments

The authors thank Kevin Smart for his help in preparing the English version of the manuscript.

APPENDIX 1

Pain Coping Strategies Questionnaire Pdf Free

CSQ-R-I, Coping Strategies Questionnaire – Revised: Italian Version

Le persone sviluppano strategie per fronteggiare e gestire il dolore che sentono. Queste strategie includono dire cose a noi stessi quando si prova dolore o quando si svolgono le attività quotidiane. Di seguito è riportato un elenco di cose che le persone hanno raccontato di fare quando provano dolore. Per cortesia, per ogni attività descritta indichi utilizzando la scala sotto riportata in che misura si sente coinvolto/a quando prova dolore.

0123456
non loogni tantolo faccio
faccio mailo facciosempre

Strategie di coping

  • Distrarsi (1,2,3,4,5): …./30

  • Catastrofismo (17,18,19,20,21,22): …./36

  • Ignorare le sensazioni dolorose: (6,7,10,11,12): …./30

  • Prendere le distanze dal dolore (13,14,15,16): …./24

  • Strategie di auto-affermazione (8,9,26,27): …./24

  • Pregare (23,24,25): …/18

DomandePunteggi
1) Immagino cose che mi fanno piacere
2) Immagino persone con cui amo divertirmi
3) Ripenso a piacevoli esperienze trascorse
4) Faccio cose che mi gratificano come guardare la televisione o ascoltare la musica
5) Cerco di pensare a qualcosa di piacevole
6) Cerco di andare avanti come se niente fosse
7) Non presto attenzione al dolore
8) Dico a me stesso che il dolore non deve interferire con ciò che faccio
9) Anche se provo dolore cerco di andare avanti
10) Non penso al dolore
11) Ignoro il dolore
12) Fingo che il dolore non ci sia
13) Immagino che il dolore sia estraneo al mio corpo
14) Fingo che il dolore non mi appartenga
15) Cerco di estraniarmi dal dolore, come se appartenesse a qualcun altro
16) Cerco di pensare che il dolore non appartenga al mio corpo ma che sia qualcosa di estraneo
17) Ho la sensazione di non poter più sopportare il dolore
18) Ho la sensazione di non riuscire ad andare avanti
19) Sono preoccupato riguardo a quando finirà il dolore
20) Ho la sensazione che non valga la pena vivere
21) Il dolore è terribile e ho la sensazione che mi travolga
22) Il dolore è terribile e ho la sensazione che non migliorerà mai
23) Prego Dio che il dolore non duri a lungo
24) Supplico che il dolore finisca
25) Confido nella fede in Dio
26) Dico a me stesso che posso superare il dolore
27) Dico a me stesso di avere coraggio e di andare avanti nonostante il dolore

Footnotes

DISCLOSURES: The authors have no conflicts of interest to declare.

Amy weiss. IRB APPROVAL: The authors’ Institutional Review Board approved the study, which was conducted in accordance with ethical and humane principles of research.

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From the desk of Dr. Rosenberg …

Six Attitude Strategies for Coping with Chronic Pain

It hurts too much… I can’t stand it one minute longer … I just want it to stop … it’s not worth it … I can't go on.

Sound familiar? These types of thoughts, running through the mind of a pain patient, are not that unusual, in fact, are common. Unfortunately, thoughts of feeling victimized, when repeatedly stated, form an attitude of defeat and end up magnifying awareness of pain sensations, limiting tolerance of pain, and continue a cyclical process of undermining coping efficiency.

Thoughts and attitudes are critical factors in determining how a person gets through the next hour, day, week, the present and the future. Here are 6 important strategies you can use immediately and repeatedly use to regain control over your thoughts and attitude. Try these active coping strategies to boost your pain tolerance and effectively limit your emotional suffering.

Handle pain in the present, in the here and now. While there is no doubt that pain sensations are very uncomfortable, it is never truly intolerable unless you believe that it so. What often exaggerates pain awareness and intensity is fear of its current intensity, worry about how much more intense it might get, this combined with worry about when it will ever end.

By staying in the present moment you CAN direct your efforts to cope with pain one moment at a time, without fearing for anynegative future. And as you succeed in tolerating pain in one moment, you end up bolstering your confidence in your ability to succeed in the next, and the next, etc. Use this method to break the pain-fear cycle.

Use pain as a signal of challenge. The usual reaction to pain flaring up, intruding more than expected, is passivity – waiting for medicine to work, limiting activities, avoiding everyone. While this may be necessary during a pain flare up, many times this is more a habitual response. Pain patients need to be aware that passive responding send you a strong message: PAIN CONTROLS MY LIFE. Instead, consider responding to a pain flare by producing a checklist of active coping strategies to follow. Challenge yourself in those pain flares to follow the checklist, using mental and physical ways (see the other steps) to cope, all which limit you feeling overwhelmed. Challenge yourself to respond more effectively to pain situations you previously thought were impossible to manage.

Use pain as a signal to relax. Muscle tension increases may increase the number and speed of pain messages sent to your brain. More tension à more pain intensity and awareness. And a stressed and worried reaction to pain sensations also interferes with pain tolerance - more stress and/or worry à more pain awareness.

Now look at the opposite. More physically relaxed responses to pain sensations means fewer, slower pain messages sent to your brain – pain is no longer an emergency. Less stress and worry, better tolerance of pain. Learn to use relaxation skills in the face of pain, bolstering your pain tolerance and coping confidence.

Pain Coping Strategies Questionnaire Pdf Free Trial

Shift your focus of concentration away from pain. Whatever your brain focuses on becomes more dominant in your awareness. Pay attention to an itch - it magnifies and gets the best of you. Pay attention to worry and it gets more frequent and distressing. Pay attention to pain, the sensation appears to magnify.

Practicing not paying attention to what is bothering you, physically or emotionally, is an important active coping skill. To do this, practice a distracting hobby, or use your 5 senses to shift focus (listen to music or watch nature, etc.). You could talk to others, but restrict the topics to non-pain issues. These ways, and many others, all break the cycle of pain magnification. Concentrate on coping, not 'paining.'

Use pain coping as a reminder of your toughness With practice of active pain coping skills you become stronger and more effective in your ability to manage pain.

Remind yourself how well you're coping and how much better you'll cope as you practice active coping skills more. Give yourself praise for efforts as well as successes. Help yourself to see how you are becoming mentally tough facing this new and difficult challenge – persistent pain. You are reasserting control, learning ways to adjust, coping with pain. Give yourself credit for your toughness.

Be prepared to deal with pain. Who would you want handling your loved one's emergency ?: 1) someone new to the situation, 2) someone who had once read a book about it, or 3) someone who is practiced and experienced in how to manage it.No contest, is it? - You would want someone who knows what they're doing à #3.

Pain Coping Strategies Questionnaire Pdf Free Download

Every chronic pain patient has emergencies. Be prepared - not just by relying on health professionals, but by relying on yourself - make yourself an active coping expert.

Think about pain situations you're likely to deal with, then write down your coping plan. Consider alternatives, backup plans. Have supplies needed available. Plan what you'll think, what you'll say to yourself, what you'll focus on, etc. Have emergency practice drills. If the crisis really comes, use your plan. Afterwards, look at what worked and what didn't. Use a crisis coping plan that you have made effective.

Knowing you have that plan to cope is half the battle - finding out how well it works will bring you feelings of self mastery.

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