Validation of the tablet-based Turkish-PAINReportIt? for lung cancer patients after thoracotomy in Turkey

Background: Digital pain assessment is advantageous and timely for healthcare priorities in Turkey. However, a multi-dimensional, tablet-based pain assessment tool is not available in the Turkish language.Purpose: To validate the Turkish-PAINReportIt (R) as a multi-dimensional measure of post-thoracotomy pain.Methods: In the first of a two-phased study, 32 Turkish patients (mean age 47.8 +/- 15.6 years, 72 % male) participated in individual cognitive interviews as they completed the tablet-based Turkish-PAINReportIt (R) once during the first four days post-thoracotomy, and 8 clinicians participated in a focus group discussion of imple-mentation barriers. In the second phase, 80 Turkish patients (mean age 59.0 +/- 12.7 years, 80 % male) completed the Turkish-PAINReportIt (R) preoperatively, on postoperative days 1-4, and at the two-week post-operative follow-up visit.Results: Patients generally interpreted accurately the Turkish-PAINReportIt (R) instructions and items. We elimi-nated some items unnecessary for daily assessment based on focus-group suggestions. In the second study phase, pain scores (intensity, quality, pattern) were low pre-thoracotomy for lung cancer and high postoperatively high on day 1, decreasing on days 2, 3 and 4, and back down to pre-surgical levels at 2-weeks. Over time, pain in-tensity decreased from post-operative day 1 to post-operative day 4 (p < .001) and from post-operative day 1 to post-operative week 2 (p < .001).Conclusions: The formative research supported proof of concept and informed the longitudinal study. Findings showed strong validity of the Turkish-PAINReportIt (R) to detect reduced pain over time as healing occurs after thoracotomy.