Psychometric Properties of the Multidimensional Impression of Change in a Cohort of Pediatric Patients With Pain

Abstract

Objectives: This study assessed the utility of the Multidimensional Patient Impression of Change (MPIC) questionnaire in a pediatric pain population after interdisciplinary treatment.

Design: Observational study with retrospective chart review. The observed treatment program included psychological counseling, relaxation training, physical therapy, occupational therapy, and physician management.

Setting: Outpatient pain management center affiliated with an academic rehabilitation hospital.

Participants: A heterogeneous group of pediatric patients with chronic pain (N=202) who completed an interdisciplinary pain management program.

Interventions: Not applicable.

Main outcome measures: Measures assessing pain, mood, development, social functioning, physical functioning, and family functioning were administered pre- and posttreatment, and the MPIC was administered posttreatment.

Results: Statistically significant improvements were observed in all outcomes (P<.05). The majority of patients perceived themselves to be improved (minimally to very much) in all clinical domains of the MPIC, ranging from 60% (medication efficacy) to 96% (coping with pain). The MPIC ratings were significantly correlated with improvements in most of the outcome measures. The MPIC domains accounted for more than half of the unique variance in predictive models when added to the Patient Global Impression of Change, and most of the variance when added to the models first.

Conclusions: The MPIC was found to be an effective screening tool for assessing patient perceived progress in a pediatric chronic pain population.

Keywords: Chronic pain; Pain management; Patient outcome assessment; Rehabilitation.