Psychological Assessment Of The Low Back Pain With A New Chinese Version Of The Fear-avoidance Beliefs Questionnaire

Objective Fear of pain and avoidance are psychology factors of primary importance when assessing chronic pain with the fear-avoidance beliefs questionnaire (FABQ). Translate the fear-avoidance belief questionnaire and to explore the validity, reliability and responsiveness of the Chinese version of the fear-avoidance belief questionnaire for evaluating patients with low back pain.Methods First, our team asked Thomas for the FABQ, which was translated into colloquial Chinese (Cantonese), assessing the patients with neck pain in Hong Kong. Thomas agreed to give us the questionnaire. Second, the questionnaire was translated into putonghua by two independent professional translators.100 (male 55, female 45; age 18-24) grade 5 university students to review the questionnaire, were by means of one-to-one interviews in order to examine the potential distribution of responses, comprehension and to ensure linguistic, face and content validity. 160 patients (male 100, female 60; age 37.88±9.40) were recruited from rehabilitation care outpatient or inpatient of the 1st and 2nd affiliated hospital of Anhui Medical University in Hefei of Anhui Province. They have to completed the following questionnaires: a general socio-demographic questionnaires, the Chinese version of the fear-avoidance beliefs questionnaire (FABQ-CHI) , 11-point pain numerical rating scale (NRS) , the Chinese version of the Oswestry disability index (ODI) and the Chinese version of the Medical Outcomes 36-Item Shot-Form Health Survey(SF-36). And 51 inpatients have to complete the FABQ-CHI again in 2 days. Results The questionnaire is a 16-item, in which is scored from 0 to 6 with higher scores indicating increased levels of fear-avoidance. It has two subscales shown by factor analysis, one subscale focusing on patients'beliefs about how physical activities affect their pain and the other focusing on patients'beliefs about how work affects their pain.The Chinese version of FABQ had very good content validity, split-half reliability and test-retest reliability with intraclass correlation coefficients of 0.809, 0.696 and Cronbach's coefficient of 0.857. Spearman's correlation coefficients between FABQ and NRS, ODI , SF-36(physical) and SF-36(mental) were0.303, 0.488,-0.350 and -0.308 respectively. Factor analysis yielded three factors which accounted for 61.2% of the total variance of questionnaire.Conclusion Our study is the first to attempt to adapt, translate and validate the fear-avoidance questionnaire for Chinese patients with low back pain. The validated Fear-avoidance Belief Questionnaire is a cost-effective clinical screening tool suitable for use by the health care professionals on Chinese patients with low back pain. The questionnaire can be used as an outcome measure and prediction of likelihood of return to work at the early phase of rehabilitation of patients with low back pain. With the increasing demand for evidence-based practice, it should contribute to future research on the effects of fear avoidance behavior on patients with low back pain.