VALIDITY AND RELIABILITY OF PAKISTANI URDU VERSION SHORT FORM McGill PAIN QUESTIONNAIRE IN POST CARDIAC SURGERY PATIENTS
DOI:
https://doi.org/10.71000/f4xxpr38Keywords:
Cardiac surgery; McGill Pain Questionnaire; Numeric Pain Rating Scale; Pain; Reliability; Short Form Health Survey; Urdu; Validity.Abstract
Background: The Short Form McGill Pain Questionnaire (SF-MPQ) is a multidimensional pain measure that captures pain intensity together with sensory and affective qualities. Linguistically appropriate validation is important when a patient-reported outcome measure is used in a population whose primary clinical language differs from the source version, particularly after cardiac surgery when pain changes rapidly during recovery.
Objective: To evaluate the validity and reliability of the Pakistani Urdu version of the SF-MPQ in patients after cardiac surgery through median sternotomy.
Methods: This observational psychometric validation study included 265 clinically stable post-cardiac-surgery patients recruited by purposive sampling from the Armed Forces Institute of Cardiology between June 2021 and June 2022. Ten experts reviewed the Urdu version for face and content validity. Concurrent validity was examined by correlating Urdu and English SF-MPQ scores on postoperative day (POD) 1. Construct validity was examined against the Numeric Pain Rating Scale (NPRS) on POD 4, 6, and 15 and against the 12-item Short Form Health Survey (SF-12) on POD 6 and 15. Internal consistency and test-retest reliability were assessed using Cronbach alpha and intraclass correlation coefficients (ICC). Exploratory factor analysis (EFA) was used to examine factor structure.
Results: The mean age was 58 +/- 9.4 years and 206/265 participants (77.7%) were male. Expert agreement for face validity was 100%, and item- and scale-level content validity indices were 1.0. Concurrent validity between the Urdu and English versions was very strong (r = 0.980, p < 0.001). Correlations with NPRS were strong across POD 4, 6, and 15 (r = 0.796-0.850, 0.809-0.846, and 0.811, respectively; all p < 0.001). Correlation with the SF-12 was weakly negative on POD 6 (r = -0.315, p < 0.001) and negligible on POD 15 (r = 0.021, p = 0.734). Overall Cronbach alpha was 0.913 on POD 4 and 0.861 on POD 6; corresponding ICCs were 0.841 and 0.755. Domain ICCs were heterogeneous: sensory 0.098, affective 0.907, intensity 0.957, and present pain intensity 0.915. EFA retained five components explaining approximately 65% of the variance; the Kaiser-Meyer-Olkin value was 0.538.
Conclusion: The Pakistani Urdu SF-MPQ demonstrated strong concurrent validity with the English version, strong convergence with NPRS, and good overall reliability in this post-cardiac-surgery sample. However, the weak association with SF-12, poor sensory-domain test-retest reliability, and marginal factorability indicate that the psychometric performance was not uniformly strong across all domains. The instrument may support Urdu-language pain assessment in similar clinically stable patients, with cautious interpretation of subscale scores and further multicentre validation.
Keywords: Cardiac surgery; McGill Pain Questionnaire; Numeric Pain Rating Scale; Pain; Reliability; Short Form Health Survey; Urdu; Validity.
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Copyright (c) 2026 Dr Mubashra Malik, Dr.Muhammad Tahir Hafeez, Fahad Tanveer, Habib Ur Rehman, Fareeha Chaudhary, Arslan Saeed, Sardar Abdul Hanan Saeed, Dr Rafia Imtiaz (Author)
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