557: Development of a Novel Questionnaire on Pain Science Education- The KNOwMorePain Questionnaire

Topic: Education, Societal Impact, and Others
Subtopic: Education of pain care

Background and Aims: Although pain science education (PSE) is increasingly implemented in clinical and research settings to promote reconceptualization of pain and adaptive lifestyle change, alignment between its transformative learning aims and current assessment approaches remains undeveloped. A recent review of PSE instruments reported substantial heterogeneity and limited psychometric robustness, highlighting the lack of theoretically grounded approaches to assess conceptual change (Reezigt et al., 2026). Therefore, we aimed to develop an instrument to assess meaningful conceptual change aligned with the core aims of PSE.

Methods: Building on the PETAL Collaboration’s synthesis of learning frameworks in PSE (Moseley et al., 2024), we developed the Spanish-language KNOwMorePain (KMP) questionnaire as an operational model capturing graded conceptual change. It was co-created with pain experts and chronic pain patients. Development comprised (1) item generation informed by literature review, focus groups and interviews, using a four-option response format; (2) expert content validation; and (3) pilot testing to examine feasibility, internal consistency, and item-level performance.

Results: The development process yielded a grounded hierarchical instrument capturing five graded levels of conceptual change across domains of pain learning- basic knowledge, cognitive reframing, applied knowledge, reflective integration, and contextual integration/sustainability. The results confirmed an excellent content validity of the items and high internal consistency. Following the PSE course, significant progress was noted across all 5 domains, with "applied knowledge" and "reflective integration" showing large effect sizes (d > 0.8). The 4-alternative format proved sensitive to subtle conceptual changes, avoiding the measurement saturation typical of simpler scales. Participants reported high acceptability and clarity.

Conclusions: The KMP questionnaire seems to be a valid and reliable tool to assess pain knowledge multidimensionally, overcoming the limitations of preexisting tools focused on dichotomous true–false factual recall or neurobiological knowledge. These preliminary results suggest that KMP is a sensitive instrument for monitoring complex shifts in applied knowledge and reflective integration, providing a more precise evaluation of PSE outcomes in clinical practice.

References: Reezigt, R. R., Beetsma, A. J., Catley, M. J., Palermo, T. M., Pate, J. W., Leake, H. B., et al. (2026). Assessing pain science education: The measurement properties of assessment instruments of conceptual change: A narrative and rapid review. The Journal of Pain. Advance online publication. https://doi.org/10.1016/j.jpain.2026.106195

Moseley, G. L., Leake, H. B., Beetsma, A. J., Watson, J. A., Butler, D. S., van der Mee, A., et al. (2024). Teaching patients about pain: The emergence of pain science education, its learning frameworks and delivery strategies. The Journal of Pain, 25(5), 104425. https://doi.org/10.1016/j.jpain.2024.104425

Roose E, Nijs J, Moseley GL. Striving for better outcomes of treating chronic pain: integrating behavioural change strategies before, during, and after modern pain science education. Braz J Phys Ther. 2023;27(6):100578. doi: 10.1016/j.bjpt.2023.100578

Moseley GL, Mardon A, Watson J, Braithwaite F, Wilson MV, Barker T, et al. From didactic explanations to co-design, sequential art and embodied learning: challenges, criticisms and future directions of patient pain education. Front Pain Res. 2025;6:1536112. doi: 10.3389/fpain.2025.1536112

Catley MJ, O'Connell NE, Moseley GL. How good is the neurophysiology of pain questionnaire? A Rasch analysis of psychometric properties. J Pain. 2013;14(8):818-827. doi: 10.1016/j.jpain.2013.02.008

Núñez-Cortés R, Salazar-Méndez J, Calatayud J, Lluch E, López-Bueno R, Horment-Lara G, et al. How do the target concepts of pain science education combined with exercise contribute to the effect on pain intensity and disability in patients with chronic spinal pain? A systematic review and meta-analysis with moderator analysis. Neurosci Biobehav Rev. 2024;163:105740. doi: 10.1016/j.neubiorev.2024.105740

Ziegler AM, Minkalis AL, Langdon ER, Vining R. Learning the neurobiology of pain: A scoping review of pain education from an instructional design perspective. Patient Educ Couns. 2022;105(6):1379-1401. doi: 10.1016/j.pec.2021.09.019

Presenting Author: UNAI GARCIA-GARCIA
Submitting Author: UNAI GARCÍA-GARCIA

Senior Author: MARIA TERESA CARRILLO-DE-LA-PEÑA

IASP 2026 Global Year theme of Neuropathic Pain: No

• MARIA LOPEZ-CORCHON - Brain and Pain lab, Institute of Psychology (IPsiUS), Universidade de Santiago de Compostela.
• UNAI GARCIA-GARCIA - Brain and Pain lab, Institute of Psychology (IPsiUS), Universidade de Santiago de Compostela.
• SARA ALVAREZ-DELGADO - Brain and Pain lab, Institute of Psychology (IPsiUS), Universidade de Santiago de Compostela.
• ALEJANDRO QUIROZ-TRONCOSO - Brain and Pain lab, Institute of Psychology (IPsiUS), Universidade de Santiago de Compostela.
• MARIA TERESA CARRILLO-DE-LA-PEÑA - Brain and Pain lab, Institute of Psychology (IPsiUS), Universidade de Santiago de Compostela.