Thursday, July 12, 2007
This presentation is part of : Measurement and Instrument Development Models
The “RAP-Ca Project”: Piloting a Pain Assessment Instrument in Patients with Cancer Pain
Kandyce M. Richards, PhD, APN, School of Nursing, University of Miami, Coral Gables, FL, USA
Learning Objective #1: discuss cancer-related pain assessment as an important measurement issue in translational research.
Learning Objective #2: describe the relationship between evaluation of the psychometric properties of an instrument and appropriate use of that instrument in a given target population.

Management of cancer-related pain presents a challenge that is at the heart of oncology nursing. There is abundant evidence that prevalence of pain among cancer patients remains high despite advances in knowledge of disease patterns and pain mechanisms. A plausible solution to improved management of pain related to cancer is an instrument that will guide comprehensive assessment of the cancer pain experience in the clinical setting. Therefore, the purpose of this pilot study was to test the psychometric properties of an inductively-derived pain assessment instrument, recently author-developed and validated with patients experiencing a variety of pain problems, in a sample of subjects reporting cancer-related pain in order to determine feasibility of conducting a larger confirmatory study of the instrument in the target population. Data were collected from 106 Hispanic, African-American and non-Hispanic White cancer patients with pain using the Richards Assessment of Pain (RAP) instrument. Exploratory factor analysis was conducted to determine construct validity of the RAP. Cronbach’s alpha was used to measure internal consistency reliability of the global scale and each of two subscales. Inferential statistics were used to explore the relationship between RAP subscales and ethnoculture, as well as other sociodemographic characteristics of the sample. Preliminary results suggest that two of the original three RAP subscales represent the most parsimonious solution for these pilot data: ‘learning to live with the pain’, and ‘thinking and feeling the pain’. Cronbach’s alpha measured 0.88 for subscale 1, 0.86 for subscale 2, and 0.92 for the global scale. Results of ANOVA’s, related post hoc tests and independent t-tests demonstrated sociodemographic health-related disparities in this sample that may suggest a profile of vulnerability to undermanagement of cancer pain. Taken together, preliminary results of this pilot study support feasibility of a larger translational study to confirm validity and reliability of the RAP in assessing cancer-related pain.