Development and preliminary testing of a comprehensive Ecological Momentary Assessment of people with chronic pain

Ecological Momentary Assessment (EMA) is a data collection method to understand people's real-time experience in daily life. To date, no standard instrument exists to measure the pain experience using EMA that provides relevant information for most chronic pain conditions. The goal of this study was to fill this gap by developing a comprehensive EMA pain instrument (cEMAp). Drawing on extant validated retrospective pain measures, the items represented the following pain-relevant constructs: (1) pain intensity, (2) pain fluctuations and patterns, (3) time in pain, (4) pain sensations, (5) pain location, (6) focusing on pain and distraction, (7) pain behavior, (8) other pain sensations, (9) pain impact, (10) pain concerns, (11) causes of pain relief and exacerbations, and (12) pain typicality. Subsequently, interviews with fifty-three adults (mean age=57 years, SD=13.4; female: 74%) with chronic pain were conducted to confirm the relevance and appropriateness of the selected items for real-time pain measurement. We then created an electronic version of the instrument utilizing information from 2-h intervals. We examined its feasibility and acceptability in a 1-week EMA design in a separate sample of twenty adults with chronic pain (mean age=56 years, SD=14.2). Results showed that EMA completion time was reasonable (mean=3.8 min, SD=2.5). Participants reported that the prompts were non-disruptive, the questions overall captured their pain experience, and the frequent pain assessments were useful. We expect this new instrument will allow researchers and clinicians to paint a fine-grained and nuanced picture of people's everyday pain in a comprehensive and standardized way. PERSPECTIVE: This article presents the development of a new pain assessment based on Ecological Momentary Assessment to comprehensively measure chronic pain in daily life. Continued use and examination of the new instrument could facilitate standardization and comparability of momentary pain assessment methods across studies and chronic pain conditions.