An Initial Psychometric Evaluation of the APS-POQ-R in Acute Pain Presenting to the Emergency Department

Background: Pain is a common presenting complaint to the emergency department (ED), yet is often undertreated. When assessing the outcomes of pain care in the ED, process measures are commonly reported. Attempts to measure patient reported outcomes existing in current ED literature. However, they are frequently unvalidated and lack standardization. The American Pain Societies, Patient Outcome Questionnaire, Revised edition (APS POQ R) has been identified as the most likely, preexisting tool to be useful in the acute pain in the ED. However, this requires feasibility and construct validation before use. Objective: To assess the feasibility and construct validity of the APS POQ R in patients presenting to the adult emergency department with acute pain. Methods: This study is an initial psychometric evaluation of the constructs contained within the APS POQ R in adult patients presenting with moderate to severe acute pain to a large urban ED. The study is guided by the methods described in the initial development of the instrument. Results: Two hundred adult patients were recruited and completed the APS POQ R. The APS POQ R demonstrated content validity in patients presenting with acute pain. Exploratory factor analysis demonstrated five subgroups. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care. Conclusions: The APS POQ R has demonstrable construct validity in adult patients presenting with acute pain to the ED. Further psychometric analysis across multiple EDs is required before the APS POQ R can be recommended as a validated PROM for ED patients in pain.