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Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Care | Research article

Back beliefs among elderly seeking health care due to back pain; psychometric properties of the Norwegian version of the back beliefs questionnaire

Authors: Alexander Tingulstad, Rikke Munk, Margreth Grotle, Ørjan Vigdal, Kjersti Storheim, Birgitta Langhammer

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

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Abstract

Background

The Back Beliefs Questionnaire (BBQ) is a 14-item patient-reported questionnaire that measures attitudes and beliefs about the consequences of back pain. The BBQ has recently been translated into Norwegian, but its psychometric properties have not yet been tested. The aim of this study is to evaluate the reliability and construct validity of the BBQ when used on elderly patients with back pain.

Method

A prospective cohort study with a test-retest design among 116 elderly patients (> 55 years of age) seeking primary care for a new episode of back pain. Test-retest, standard error of measurement (SEM), minimal detectable change (MDC), internal consistency and construct validity by a priori hypotheses (Spearman’s- and Pearson correlation coefficient) were tested.

Results

A total of 116 patients, mean age (SD) 67.7 (8.3), were included and 63 patients responded to the test-retest assessment. The mean (SD) BBQ sum scores (range 9–45) were 29.8 (7.0) and 29.2 (6.7) for the test and retest respectively. The test-retest was acceptable with an intraclass correlation coefficient of 0.71 (95% CI, 0.54–0.82), SEM was 3.8 and MDC 10.5. Internal consistency with Cronbach’s alpha was good (0.82) and acceptable construct validity was supported by the confirmation of 75% of the a priori hypotheses.

Conclusion

The Norwegian version of the BBQ demonstrated acceptable test-retest reliability and good construct validity and can be used to assess pessimistic beliefs in elderly patients with back pain.
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Literature
1.
go back to reference GBD. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet (London, England). 2018;392(10159):1859–922.CrossRef GBD. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet (London, England). 2018;392(10159):1859–922.CrossRef
2.
go back to reference Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS. The rising prevalence of chronic low Back pain. Arch Intern Med. 2009;169(3):251–8.CrossRef Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS. The rising prevalence of chronic low Back pain. Arch Intern Med. 2009;169(3):251–8.CrossRef
3.
go back to reference Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, et al. What low back pain is and why we need to pay attention. Lancet (London, England). 2018;391(10137):2356–67.CrossRef Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, et al. What low back pain is and why we need to pay attention. Lancet (London, England). 2018;391(10137):2356–67.CrossRef
4.
go back to reference Paeck T, Ferreira ML, Sun C, Lin CWC, Tiedemann A, Maher CG. Are older adults missing from low Back pain clinical trials? A systematic review and meta-analysis. Arthritis Care Res. 2014;66(8):1220–6.CrossRef Paeck T, Ferreira ML, Sun C, Lin CWC, Tiedemann A, Maher CG. Are older adults missing from low Back pain clinical trials? A systematic review and meta-analysis. Arthritis Care Res. 2014;66(8):1220–6.CrossRef
5.
go back to reference Symonds TL, Burton AK, Tillotson KM, Main CJ. Do attitudes and beliefs influence work loss due to low back trouble? Occup Med(Lond). 1996;46(1):25–32.CrossRef Symonds TL, Burton AK, Tillotson KM, Main CJ. Do attitudes and beliefs influence work loss due to low back trouble? Occup Med(Lond). 1996;46(1):25–32.CrossRef
6.
go back to reference Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52(2):157–68.CrossRef Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52(2):157–68.CrossRef
7.
go back to reference Grotle M, Brox J, Glomsrød B, Lønn J, Veierød M, Vølllestad N. Clinical course and prognostic factors in acute low back pain: patients seeking help for their first time. Ann Rheum Dis. 2004;63:91–2.CrossRef Grotle M, Brox J, Glomsrød B, Lønn J, Veierød M, Vølllestad N. Clinical course and prognostic factors in acute low back pain: patients seeking help for their first time. Ann Rheum Dis. 2004;63:91–2.CrossRef
8.
go back to reference George SZ, Beneciuk JM. Psychological predictors of recovery from low back pain: a prospective study. BMC Musculoskelet Disord. 2015;16(1):49.CrossRef George SZ, Beneciuk JM. Psychological predictors of recovery from low back pain: a prospective study. BMC Musculoskelet Disord. 2015;16(1):49.CrossRef
9.
go back to reference Elfering A, Anne FM, Nicola J, Oezguer T, Urs M. Beliefs about Back pain predict the recovery rate over 52 consecutive weeks. Scand J Work Environ Health. 2009;35(6):437–45.CrossRef Elfering A, Anne FM, Nicola J, Oezguer T, Urs M. Beliefs about Back pain predict the recovery rate over 52 consecutive weeks. Scand J Work Environ Health. 2009;35(6):437–45.CrossRef
10.
go back to reference Elfering A, Müller U, Rolli Salathé C, Tamcan Ö, Mannion AF. Pessimistic back beliefs and lack of exercise: a longitudinal risk study in relation to shoulder, neck, and back pain. Psychol Health Med. 2015;20(7):767–80.CrossRef Elfering A, Müller U, Rolli Salathé C, Tamcan Ö, Mannion AF. Pessimistic back beliefs and lack of exercise: a longitudinal risk study in relation to shoulder, neck, and back pain. Psychol Health Med. 2015;20(7):767–80.CrossRef
11.
go back to reference Buchbinder R, Jolley D, Wyatt M. Population based intervention to change back pain beliefs and disability: three part evaluation. BMJ. 2001;322(7301):1516.CrossRef Buchbinder R, Jolley D, Wyatt M. Population based intervention to change back pain beliefs and disability: three part evaluation. BMJ. 2001;322(7301):1516.CrossRef
12.
go back to reference Bowey-Morris J, Davis S, Purcell-Jones G, Watson PJ. Beliefs about Back pain: results of a population survey of working age adults. Clin J Pain. 2011;27(3):214–24.CrossRef Bowey-Morris J, Davis S, Purcell-Jones G, Watson PJ. Beliefs about Back pain: results of a population survey of working age adults. Clin J Pain. 2011;27(3):214–24.CrossRef
13.
go back to reference Werner EL, Ihlebæk C, Lærum E, Wormgoor MEA, Indahl A. Low back pain media campaign: no effect on sickness behaviour. Patient Educ Couns. 2008;71(2):198–203.CrossRef Werner EL, Ihlebæk C, Lærum E, Wormgoor MEA, Indahl A. Low back pain media campaign: no effect on sickness behaviour. Patient Educ Couns. 2008;71(2):198–203.CrossRef
14.
go back to reference Maki D, Rajab E, Watson PJ, Critchley DJ. Cross-cultural translation, adaptation and psychometric properties of the back beliefs questionnaire in modern standard Arabic, vol. 101; 2015. p. e937. Maki D, Rajab E, Watson PJ, Critchley DJ. Cross-cultural translation, adaptation and psychometric properties of the back beliefs questionnaire in modern standard Arabic, vol. 101; 2015. p. e937.
15.
go back to reference Alamrani S, Alsobayel H, Alnahdi AH, Moloney N, Mackey M: Cross-Cultural Adaptation and Validation of the Back Beliefs Questionnaire to the Arabic Language. Spine 2016;41(11):E681–68.CrossRef Alamrani S, Alsobayel H, Alnahdi AH, Moloney N, Mackey M: Cross-Cultural Adaptation and Validation of the Back Beliefs Questionnaire to the Arabic Language. Spine 2016;41(11):E681–68.CrossRef
16.
go back to reference Burnett A, Sze CC, Tam SM, Yeung KM, Leong M, Wang WT, Tan BK, O'Sullivan P. A cross-cultural study of the Back pain beliefs of female undergraduate healthcare students. Clin J Pain. 2009;25(1):20.CrossRef Burnett A, Sze CC, Tam SM, Yeung KM, Leong M, Wang WT, Tan BK, O'Sullivan P. A cross-cultural study of the Back pain beliefs of female undergraduate healthcare students. Clin J Pain. 2009;25(1):20.CrossRef
17.
go back to reference Chen G, Tan BK, Jia H-L, O'Sullivan P, Burnett A. Questionnaires to examine Back pain beliefs held by health care professionals: a psychometric evaluation of simplified Chinese versions. Spine. 2011;36(18):1505.CrossRef Chen G, Tan BK, Jia H-L, O'Sullivan P, Burnett A. Questionnaires to examine Back pain beliefs held by health care professionals: a psychometric evaluation of simplified Chinese versions. Spine. 2011;36(18):1505.CrossRef
18.
go back to reference Dupeyron A, Lanhers C, Bastide S, Alonso S, Toulotte M, Jourdan C, Coudeyre E. The Back Belief Questionnaire is efficient to assess false beliefs and related fear in low back pain populations: A transcultural adaptation and validation study.(Research Article). PLoS ONE. 2017;12(12):e0186753.CrossRef Dupeyron A, Lanhers C, Bastide S, Alonso S, Toulotte M, Jourdan C, Coudeyre E. The Back Belief Questionnaire is efficient to assess false beliefs and related fear in low back pain populations: A transcultural adaptation and validation study.(Research Article). PLoS ONE. 2017;12(12):e0186753.CrossRef
19.
go back to reference Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRef Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRef
20.
go back to reference Scheele J, Luijsterburg P, Ferreira ML, Maher CG, Pereira L, Peul WC, van Tulder MW, Bohnen AM, Berger MY, Bierma-Zeinstra SMA, et al. Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium.(Study protocol)(Report). BMC Musculoskelet Disord. 2011;12:193.CrossRef Scheele J, Luijsterburg P, Ferreira ML, Maher CG, Pereira L, Peul WC, van Tulder MW, Bohnen AM, Berger MY, Bierma-Zeinstra SMA, et al. Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium.(Study protocol)(Report). BMC Musculoskelet Disord. 2011;12:193.CrossRef
21.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–91.CrossRef Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–91.CrossRef
22.
go back to reference Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976). 1983;8(2):141–4.CrossRef Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976). 1983;8(2):141–4.CrossRef
23.
go back to reference Sullivan MJL, Bishop SR, Pivik J, Butcher JN. The pain Catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524–32.CrossRef Sullivan MJL, Bishop SR, Pivik J, Butcher JN. The pain Catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524–32.CrossRef
24.
go back to reference Grotle M, Vøllestad NK, Brox JI. Reliability, validity and responsiveness of the fear-avoidance beliefs questionaire: methodological aspects of the Norwegian version. J Rehabil Med. 2006;38(6):346–53.CrossRef Grotle M, Vøllestad NK, Brox JI. Reliability, validity and responsiveness of the fear-avoidance beliefs questionaire: methodological aspects of the Norwegian version. J Rehabil Med. 2006;38(6):346–53.CrossRef
25.
go back to reference Grotle M, Vøllestad M, Brox M. Cross-cultural adaptation of the Norwegian versions of the Roland-Morris disability questionnaire and the Oswestry disability index. J Rehabil Med. 2003;35(5):241–7.CrossRef Grotle M, Vøllestad M, Brox M. Cross-cultural adaptation of the Norwegian versions of the Roland-Morris disability questionnaire and the Oswestry disability index. J Rehabil Med. 2003;35(5):241–7.CrossRef
26.
go back to reference Fernandes L, Storheim K, Lochting I, Grotle M. Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain; 2012.CrossRef Fernandes L, Storheim K, Lochting I, Grotle M. Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain; 2012.CrossRef
27.
go back to reference Strong J, Ashton R, Chant D. Pain intensity measurement in chronic low back pain. Clin J Pain. 1991;7(3):209–18.CrossRef Strong J, Ashton R, Chant D. Pain intensity measurement in chronic low back pain. Clin J Pain. 1991;7(3):209–18.CrossRef
28.
go back to reference Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.CrossRef Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.CrossRef
29.
go back to reference Andresen EM. Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil. 2000;81:S15–20.CrossRef Andresen EM. Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil. 2000;81:S15–20.CrossRef
30.
go back to reference Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Earlbaum Associates; 1988. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Earlbaum Associates; 1988.
31.
go back to reference Bostick GP, Schopflocher D, Gross DP. Validity evidence for the back beliefs questionnaire in the general population. Eur J Pain. 2013;17(7):1074–81.CrossRef Bostick GP, Schopflocher D, Gross DP. Validity evidence for the back beliefs questionnaire in the general population. Eur J Pain. 2013;17(7):1074–81.CrossRef
32.
go back to reference Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37.CrossRef Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37.CrossRef
33.
go back to reference Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR. Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women.(Research article)(Report). BMC Musculoskel Disord. 2008;9(148):148.CrossRef Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR. Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women.(Research article)(Report). BMC Musculoskel Disord. 2008;9(148):148.CrossRef
34.
go back to reference Cheung P, Wong C, Cheung J. Psychometric validation of the cross-culturally adapted traditional Chinese version of the Back beliefs questionnaire (BBQ) and fear-avoidance beliefs questionnaire (FABQ). Eur Spine J. 2018;27(8):1724–33.CrossRef Cheung P, Wong C, Cheung J. Psychometric validation of the cross-culturally adapted traditional Chinese version of the Back beliefs questionnaire (BBQ) and fear-avoidance beliefs questionnaire (FABQ). Eur Spine J. 2018;27(8):1724–33.CrossRef
35.
36.
go back to reference Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing. 2006;35(3):229–34.CrossRef Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing. 2006;35(3):229–34.CrossRef
37.
go back to reference De Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press; 2011.CrossRef De Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press; 2011.CrossRef
38.
go back to reference Pallant J. SPSS survival manual : a step by step guide to data analysis using IBM SPSS. 6th ed. Maidenhead: McGraw Hill; 2016. Pallant J. SPSS survival manual : a step by step guide to data analysis using IBM SPSS. 6th ed. Maidenhead: McGraw Hill; 2016.
39.
go back to reference Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53–5.CrossRef Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53–5.CrossRef
40.
go back to reference Briggs AM, Jordan JE, Buchbinder R, Burnett AF, O’sullivan PB, Chua JYY, Osborne RH, Straker LM. Health literacy and beliefs among a community cohort with and without chronic low back pain. Pain. 2010;150(2):275–83.CrossRef Briggs AM, Jordan JE, Buchbinder R, Burnett AF, O’sullivan PB, Chua JYY, Osborne RH, Straker LM. Health literacy and beliefs among a community cohort with and without chronic low back pain. Pain. 2010;150(2):275–83.CrossRef
Metadata
Title
Back beliefs among elderly seeking health care due to back pain; psychometric properties of the Norwegian version of the back beliefs questionnaire
Authors
Alexander Tingulstad
Rikke Munk
Margreth Grotle
Ørjan Vigdal
Kjersti Storheim
Birgitta Langhammer
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2910-8

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