Improving scientific pain knowledge and attitudes of health care professionals

Cross-cultural adaptation and psychometric testing of the French version of the Knowledge and Attitudes of Pain (KNAP) questionnaire

Considering Precision and Utility When we Talk About Pain.

We applaud many of the sentiments put forward by Cohen et al in their critique of language and logic in pain medicine. 8 Pleas to avoid conflation between nociception and pain are not new - “The mislabelling of nociceptors as pain fibres was not an elegant simplification but a most unfortunate trivialisation of pain”29 ; “.. we don't actually have ‘pain receptors’, or ‘pain nerves’ or ‘pain pathways’ or ‘pain centres.’”4 We are among those who see such conflation as contrasting with contemporary understandings of ‘how pain works’ and undermining evidence-based treatment approaches.

Assessing future health care practitioners’ knowledge and attitudes of musculoskeletal pain; development and measurement properties of a new questionnaire

Background: Healthcare practitioner beliefs influence patients’ beliefs and health outcomes in musculoskeletal (MSK) pain. A validated questionnaire based on modern pain neuroscience assessing Knowledge and Attitudes ofPain (KNAP) was unavailable.Objectives: The aim of this study was to develop and test measurement properties of KNAP.Design: Phase 1; Development of KNAP reflecting modern pain neuroscience and expert opinion. Phase 2; a crosssectional and longitudinal study among Dutch physiotherapy students.Method: In the cross-sectional study (n = 424), internal consistency, structural validity, hypotheses testing, and Rasch analysis were examined. Longitudinal designs were applied to analyse test-retest reliability (n = 156), responsiveness, and interpretability (n = 76).Results: A 30-item KNAP was developed in 4 stages. Test-retest reliability: ICC (2,1) 0.80. Internal consistency: Cronbach’s α 0.80. Smallest Detectable Difference 90%: 4.99 (4.31; 5.75). Structural validity: exploratory factor analysis showed 2 factors. Hypotheses testing: associations with the Pain Attitudes and Beliefs Scale for Physiotherapists biopsychosocial subscale r = 0.60, with biomedical subscale r = 􀀀 0.58, with the Neurophysiology of Pain Questionnaire r = 0.52. Responsiveness: 93% improved on KNAP after studying pain education. MinimalImportant Change: 4.84 (95%CI: 2.77; 6.91).Conclusions: The KNAP has adequate measurement properties. This new questionnaire could be useful to evaluate physiotherapy students’ knowledge and attitudes of modern pain neuroscience that could help to create awareness and evaluate physiotherapy education programs, and ultimately provide better pain management.