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Updated: Oct 4, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Preterm Labor Pain: Validation study for the multidimensional Angle Labor Pain Questionnaire
Pamela Angle1, Brooke Pardy2, Alex J Kiss3
1Obstetrical Anesthesia Research Unit, Sunnybrook Research Institute, 2075 Bayview Ave, North York, M4N 3M5 Canada; Department of Anesthesia, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, M4N 3M5 Canada; DAN Women & Babies Program, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, North York, M4N 3M5 Canada; Department of Anesthesia, University of Toronto, 123 Edward St #1201, Toronto, M4G 0A8 Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St #425, Toronto, M5T 3M6 Canada; Department of Obstetrics and Gynaecology, University of Toronto, 1 King's College Circle #3157, Toronto, M5S 1A8 Canada.
Background:
Women's Retrospective work and clinical experience suggest that research is needed to better understand, manage, and treat women's pain during preterm childbirth remains poorly understood. Clinical experience and retrospective research suggest that difficulty diagnosing the onset of preterm labor may delay effective pain relief. However, our literature review found no prospective studies that directly examined women's multidimensional pain experiences during preterm labor or directly compared them with term birth. These knowledge gaps are best addressed using pain tools specifically developed/validated for childbirth, such as the Angle Labor Pain Questionnaire, the only multidimensional instrument developed/validated for measuring changes in labor pain. Previous validation research supports A-LPQ use during term labor; this study examined its performance in preterm labor.
Methods:
Two versions of the A-LPQ were administered in random order sequence during two Test sessions during early active unmedicated preterm labor. Overall pain intensity (Numeric Rating Scale (NRS), Verbal Rating Scale (VRS), pain coping (Pain Mastery Scale (PMS)), and pain mapping were assessed during each Test. Changes in pain between Tests were examined using the Patient Global Impression of Change Scale. Test-retest reliability, Cronbach's alpha, sensitivity to change/responsiveness, and concurrent validity were examined.
Results:
Sixty datasets were analyzed. A-LPQ Summary (total) and subscale scores demonstrated good to excellent test-retest reliability (ICC's 0.82 to 0.92, p < .001) and acceptable to excellent Cronbach's alpha (A-LPQ Summary scores ≥0.92, subscales 0.71 to 0.92). Sensitivity to change and responsiveness were supported. Strong correlations between A-LPQ Summary scores and NRS (ρ >.79), VRS (ρ >.68), and PMS scores (ρ >.67) supported concurrent validity. Concurrent validity of subscales was supported.
Conclusions:
Findings support A-LPQ use during preterm labor and in comparative studies with term labor.