1. 2017;20;E367-E378Pain-Related Limitations in Daily Activities Following Thoracic Surgery in a United States Population
   Retrospective Review
   Emine O. Bayman, PhD, Richard Lennertz, MD, PhD, and Timothy J. Brennan, MD, PhD.

BACKGROUND: Ringsted et al created a statistically validated questionnaire to assess pain-related limitations in daily activities following thoracic surgery and translated it to English. We utilized the questionnaire to assess the impact of pain impairing certain daily activities in a United States thoracic surgery population.

OBJECTIVES: Examine if the questionnaire developed and translated to English by Ringsted et al to assess the effects of chronic pain after thoracic surgery on daily activities would be applicable in a sample of thoracic surgery patients in the United States.

STUDY DESIGN: Cross-sectional study by mailed questionnaire.

SETTING: All patients who had thoracic surgery between 6 months and 3 years ago at a university hospital.

METHODS: We sent questionnaires to patients who had undergone thoracic surgery between 6 months and 3 years ago, yielding a sample of 349 eligible patients. Questionnaire results were statistically assessed for item fit, dimensionality, and internal reliability.

RESULTS: The response rate was 26.4%. Of the responders, 36% (95% CI: 26.1% to 46.5%) identified themselves as having chronic pain related to their thoracic surgery. Activities such as lying on the operated side, coughing, and carrying groceries were impaired in more than 50% of the patients who had thoracic surgery related pain (P < 0.05). Patients with chronic pain were more likely to report pain in other body locations. Few activities were limited in the patients identifying themselves as not having chronic pain. Statistical measures indicate high internal reliability.

LIMITATIONS: This was a retrospective questionnaire with 26.4% response rate.

CONCLUSIONS: Pain continues to impair the daily activities of a significant proportion of patients after thoracic surgery in a sample from the United States. Despite cultural differences, the Danish procedure-specific questionnaire provides an applicable and similar assessment of functional impairment after thoracic surgery in American patients.

Key words: Thoracic surgery, chronic pain, impairment, daily life, questionnaire