The Concept of Pain Inventory (COPI): assessing a child's concept of pain

Joshua W. Pate, Laura E. Simons, Mark J. Hancock, Julia M. Hush, Tim Noblet, Meg Pounder, Verity Pacey

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)


    Objectives: Clinical guidelines recommend that health care providers assist children to understand their experience of persistent pain, with pain science education a key component of clinical management in pediatric pain clinics. Currently, no tool exists to assess a child's concept of pain. The aim of this study was to develop such a tool and to evaluate its psychometric properties. Methods: After a rigorous process to generate items, assess content validity, evaluate readability and understandability, and pretest items, a cohort of 124 children (aged 8 to 12 y) independently completed the measure on 2 occasions, along with additional measures of pain, function, and pain-related distress. Results: The resulting unidimensional 14-item Concept of Pain Inventory (COPI) had acceptable internal consistency (α= 0.78) and moderate test-retest reliability (intraclass correlation coefficient (3,1) = 0.55; 95% CI, 0.37-0.68). Higher COPI scores reflect greater alignment with contemporary pain science. COPI scores were inversely correlated with pain intensity and functional disability, but unrelated to pain catastrophizing and pain-related fear. At 1 to 2 months' follow-up, baseline COPI scores were inversely correlated with clinical variables of functional disability and pain intensity. Discussion: These results support the COPI as a brief, psychometrically sound tool to assess a child's concept of pain. Clinically, this tool may facilitate individualized pain science education to target identified conceptual "gaps" or misconceptions and to evaluate the effectiveness of pain science education in children. Further research examining its efficacy and impact is warranted.

    Original languageEnglish
    Pages (from-to)940-949
    Number of pages10
    JournalClinical Journal of Pain
    Issue number12
    Early online date21 Sept 2020
    Publication statusPublished - Dec 2020


    • children
    • concept of pain
    • pain science education
    • questionnaire
    • scale development


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