Validation of the Chinese Version Breakthrough Pain Assessment Tool in Cancer Patients

Abstract

Background: Patient-reported outcome measures are essential for clinical practice and can also be utilized for auditing purposes to assess the effectiveness of symptom management. Identifying breakthrough pain (BTP) is crucial for managing cancer pain; however, no suitable tool exists in Chinese to evaluate the severity and analgesic reactions associated with BTP.

Purpose: This study aimed to translate the Breakthrough Pain Assessment Tool (BAT) into a Chinese version (BAT-C) and to conduct reliability and validity tests.

Methods: A prospective, descriptive, cross-sectional design was used. Participants were recruited from the oncology departments in Taiwan (N = 160). Instruments included the BAT-C, the Chinese version of the Brief Pain Inventory, and demographic and disease information. Reliability was established by calculating Cronbach's and test-retest reliability. Validity was estimated using construct validity, convergent validity, and known group validity.

Results: The internal consistency was 0.75. The construct validity of the BAT-C was estimated by exploratory factor analysis, the cumulative explained variance of which was 52.93%. Convergent validity showed a significant correlation with pain severity (r = -0.60, p < .01) and pain interference (r = -0.60, p < .01). There was a significant difference among concurrent empirical validity, analgesics (PRN) (t (160) = -5.74, p < .001). Known group validity demonstrated that inpatients had more pain interference than did outpatients (p < .01).

Conclusions: The BAT-C demonstrates good reliability and validity. It can comprehensively assess the severity, analgesic response, and side effects of cancer BTP and could potentially improve BTP management.

Keywords: Breakthrough Pain Assessment Tool (BAT) into Chinese version (BAT-C); Cancer breakthrough pain; Psychometric test; Reliability; Validity.