Initial Psychometric Testing of a Pain Quality Pictogram Tool Among Hmong Limited English Proficient and Bilingual Community Members and Healthcare Practitioners

Maichou Lor; Nora Cate Schaeffer; Roger Brown

doi:10.1016/j.pmn.2024.01.005

Initial Psychometric Testing of a Pain Quality Pictogram Tool Among Hmong Limited English Proficient and Bilingual Community Members and Healthcare Practitioners

Pain Manag Nurs. 2024 Mar 1:S1524-9042(24)00007-9. doi: 10.1016/j.pmn.2024.01.005. Online ahead of print.

Authors

Maichou Lor¹, Nora Cate Schaeffer², Roger Brown³

Affiliations

¹ University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin. Electronic address: Mlor2@wisc.edu.
² University of Wisconsin-Madison, Department of Sociology, Madison, Wisconsin.
³ University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin.

PMID: 38431504
DOI: 10.1016/j.pmn.2024.01.005

Abstract

Purpose: To assess the matching and content validity of a pain quality pictogram tool with a Hmong community.

Design: A Qualtrics survey was administered to two groups of participants.

Methods: Sixty Hmong participants (n = 49 limited English proficiency and bilingual Hmong community members in group 1; n = 11 bilingual Hmong healthcare practitioners in group 2) participated in this study. Hmong community members in group 1 were asked to identify the pain pictogram that best matched a pre-recorded Hmong pain quality phrase. The practitioners in group 2 were asked to evaluate how well each pain pictogram represented the pre-recorded Hmong pain quality phrase it intended to measure. To assess the matching, we assessed agreement between the pain concept in the phrase and the pictogram intended to represent it, using group 1. A content validity index (CVI) was calculated to assess the content validity of the tool using group 2.

Results: Among the community participants, 8 of the 15 pictograms were matched with the intended phrase almost perfectly, and 3 were matched by a substantial majority. There were no differences in matching by patient gender and language proficiency. Among practitioners, 11 of 15 pain pictograms met the CVI threshold of 0.70 for all three dimensions (i.e., representativeness, relevance, and comprehension).

Conclusion: Findings support including most of the pain pictograms in the tool but suggest specific areas for improvement.

Clinical implications: Findings provide insights for redesigning the selected pain pictogram tool to be used in clinical settings with LEP Hmong patients.