Cultural adaptation, translation and validation of two questionnaires that assess knowledge and attitudes on pain for Dutch and German citizens with low SES/health literacy in the Ems-Dollart region: the PCQ and PACKA questionnaires

BACKGROUND: Chronic pain significantly impacts the health-related quality of life and well-being of citizens in the Ems-Dollard Region (EDR), which is characterized by lower socioeconomic status (SES), rural area, and relatively high prevalence of physically demanding jobs. Low SES is a key determinant of health literacy. Improving health literacy can lead to reduced pain intensity in chronic pain populations through better pain management and increased knowledge of pain medication. For the development and evaluation of interventions aimed at creating awareness about one's thoughts on pain, understanding how pain works, and teaching people how to effectively manage pain, valid questionnaires are necessary. MAIN RESEARCH QUESTIONS: The two main aims of this study with corresponding sub-aims are: 1) To translate and culturally adapt the PCQ to a Dutch and German language version and subsequently investigate the psychometric properties (internal consistency, test-retest reliability, content validity, and known groups validity) to validate the Dutch and German translated PCQ that measures beliefs about pain in people with low SES in the EDR. a. Sub-study 1: How reliable and valid is the Dutch version of the PCQ in measuring in Dutch-speaking populations with a low SES? b. Sub-study 2: How reliable and valid is the German version of the PCQ in measuring beliefs about pain in German-speaking populations with a low SES? 2) To develop and culturally adapt the Dutch PACKA questionnaire, to translate and culturally adapt the Dutch PACKA to a German language version, and subsequently investigate the psychometric properties (internal consistency, test-retest reliability, content validity, and known groups validity) to validate the Dutch and German translated PACKA questionnaire that measures pain knowledge and attitudes towards pain in people with low SES in the EDR. a. Sub-study 3: How reliable and valid is the Dutch version of the PACKA questionnaire in measuring pain knowledge and attitudes towards pain in Dutch-speaking populations with a low SES? b. Sub-study 4: How reliable and valid is the German version of the PACKA questionnaire in measuring pain knowledge and attitudes towards pain in German-speaking populations with a low SES?