Back pain attitudes questionnaire developed

By Lucy Piper, Senior medwireNews Reporter

Researchers have developed a back pain screening tool that assesses the attitudes of patients with back pain, the general population and healthcare professionals.

Developed from in-depth qualitative interviews with 23 people experiencing acute or chronic back pain, the Back Pain Attitudes Questionnaire (Back-PAQ) could be used for future cross-sectional studies or as an outcome assessment instrument, says the team, led by Ben Darlow (University of Otago, Wellington, New Zealand).

The original long form of the scale, comprising 34 items and based on six themes, was posted to 1000 randomly selected people in New Zealand. Data from 602 responses confirmed that the scale had acceptable internal consistency (Cronbach’s α=0.70), which was not significantly improved with the removal of any items.

Exploratory analysis to identify the principal components that gave the maximum distinction produced a 10-item scale that was appropriate for both men and women. This captured four of the original six themes, namely, “the vulnerability of the back”, “the relationship between back pain and injury”, “activity participation while experiencing back pain”, and “the prognosis of back pain” as well as the additional component “psychological influences on recovery”. Together, these five themes accounted for 74.0% of the variance in the 10-item data set, and individually, they explained between 13.7% and 16.7% of the variance.

Internal consistency was acceptable for this 10-item scale (Cronbach’s α=0.61) and the individual items (α between 0.50 and 0.78).

The researchers suggest that the 34-item long form of the scale could be useful for conducting cross-sectional surveys, while the 10-item short form may be used to measure changes in beliefs or as a screening tool to predict outcome or treatment management.

“The novel scoring system for the Back-PAQ means that it is very easy to interpret”, they point out in BMJ Open. “Negative scores indicate beliefs which are presumed to be unhelpful for recovery from back pain, and positive scores vice versa.”

The researchers add: “The five components may also indicate to health professionals areas in which a patient has unhelpful beliefs, so that they may focus explanation and reassurance on these areas.”

But they acknowledge that further testing of the 10-item scale’s construct validity, reliability, responsiveness to change and predictive ability is needed.

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