Top

European Spine Journal

Published in:

01-05-2013 | Original Article

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

Authors: Julio Domenech, Eva Segura-Ortí, Juan Francisco Lisón, Begoña Espejo-Tort, Daniel Sánchez-Zuriaga

Published in: European Spine Journal | Issue 5/2013

Abstract

Objective

To develop a Spanish version of the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and to test its psychometric properties.

Methods

A forward and backward translation methodology was used to translate the questionnaire, which was then applied to 206 participants (174 physiotherapy students and 32 family physicians). The intraclass correlation coefficient was calculated to assess test–retest reliability. Internal consistency was evaluated using Cronbach’s alpha and item analysis. Construct validity was measured using Pearson correlation coefficients between HC-PAIRS and FABQ, FABQ-Phys, FABQ-Work and the responses given by participants to three clinical case scenarios. An exploratory factor analysis was carried out following the Kaiser normalization criteria and principal axis factoring with an oblique rotation (quartimax). Sensitivity to change was assessed after a teaching module.

Results

Test–retest reliability was ICC 0.50 (p < 0.01) and Cronbach’s alpha was 0.825. The HC-PAIRS scores correlated significantly with the scores of the FABQ and also with the recommendations for work and activity given by the participants in the three clinical case scenarios. Sensitivity to change test showed an effect size of 1.5, which is considered a large change. Factor analysis suggests that the Spanish version of HC-PAIRS measures a unidimensional construct.

Conclusion

The Spanish version of the HC-PAIRS has proven to be a reliable, valid and sensitive instrument to assess health care providers’ attitudes and beliefs about LBP. It can be used in evaluating clinical practice and in undergraduate acquisition of skills and knowledge.

Deyo RA, Mirza SK, Martin BI (2006) Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine 31:2724–2727PubMedCrossRef

Carragee EJ, Alamin TF, Miller JL, Carragee JM (2005) Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Spine J 5:24–35PubMedCrossRef

Chou R, Fu R, Carrino JA, Deyo RA (2009) Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet 373:463–472PubMedCrossRef

Picavet HSJ, Vlaeyen JWS, Schouten SAG (2002) Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am J Epidemiol 156:1028–1034PubMedCrossRef

Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 27:E109–E120PubMedCrossRef

Bishop A, Foster NE (2005) Do physical therapists in the United Kingdom recognize psychosocial factors in patients with acute low back pain? Spine 30:1316–1322PubMedCrossRef

Francke AL, Smit MC, de Veer AJ, Mistiaen P (2008) Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC Med Inform Decis Mak 8:38. doi:10.1186/1472-6947-8-38 PubMedCrossRef

Gonzalez-Urzelai V, Palacio-Elua L, Lopez-de-Muniain J (2003) Routine primary care management of acute low back pain: adherence to clinical guidelines. Eur Spine J 12:589–594PubMedCrossRef

Parsons S, Harding G, Breen A, Foster N, Pincus T, Vogel S, Underwood M (2007) The influence of patients’ and primary care practitioners’ beliefs and expectations about chronic musculoskeletal pain on the process of care: a systematic review of qualitative studies. Clin J Pain 23:91–98PubMedCrossRef

10.

Coudeyre E, Rannou F, Tubach F, Baron G, Coriat F, Brin S, Revel M, Poiraudeau S (2006) General practitioners’ fear-avoidance beliefs influence their management of patients with low back pain. Pain 124:330–337PubMedCrossRef

11.

Poiraudeau S, Rannou F, Le Henanff A, Coudeyre E, Rozenberg S, Huas D, Martineau C, Jolivet-Landreau I, Revel M, Ravaud P (2006) Outcome of subacute low back pain: influence of patients’ and rheumatologists’ characteristics. Rheumatology 45:718–723PubMedCrossRef

12.

Vlaeyen JWS, Linton SJ (2006) Are we “fear-avoidant”? Pain 124:240–241PubMedCrossRef

13.

Rainville J, Bagnall D, Phalen L (1995) Health care providers’ attitudes and beliefs about functional impairments and chronic back pain. Clin J Pain 11:287–295PubMedCrossRef

14.

Houben RM, Vlaeyen JWS, Peters M, Ostelo RW, Wolters PM, Stompvan den Berg SG (2004) Health care providers’ attitudes and beliefs towards common low back pain: factor structure and psychometric properties of the HC-PAIRS. Clin J Pain 20:37–44PubMedCrossRef

15.

Burnett A, Sze CC, Tam SM, Yeung KM, Leong M, Wang WT, Tan BK, O’Sullivan P (2009) A cross-cultural study of the back pain beliefs of female undergraduate healthcare students. Clin J Pain 25:20–28PubMedCrossRef

16.

Ferreira PH, Ferreira ML, Latimer J, Maher C, Refshauge K, Sakamoto A, Garofalo R (2004) Attitudes and beliefs of Brazilian and Australian physiotherapy students towards chronic back pain: a cross cultural comparison. Physiother Res Int 9:13–23PubMedCrossRef

17.

Latimer J, Maher C, Refshauge K (2004) The attitudes and beliefs of physiotherapy students to chronic back pain. Clin J Pain 20:45–50PubMedCrossRef

18.

Kovacs FM, Muriel A, Abriaira V, Medina JM, Castillo-Sanchez MD, Olabe J (2005) The influence of fear avoidance beliefs on disability and quality of life is sparse in Spanish low back pain patients. Spine 30:676–682CrossRef

19.

Bullinger M, Alonso J, Apolone G, Leplege A, Sullivan M, Wood- Dauphinee S, Gandek B, Wagner A, Aaronson N, Bech P, Fukuhara S, Kaasa S, Ware JE (1998) Translating health status questionnaires and evaluating their quality: the IQOL A project approach. International quality of life assessment. J Clin Epidemiol 51:913–923PubMedCrossRef

20.

Waddell G, Newton M, Henderson I, Somerville D, Main CJ (1993) A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 52:157–168PubMedCrossRef

21.

Kovacs FM, Muriel A, Medina JM, Abraira V, Castillo MD, Olabe J (2006) Psychometric characteristics of the Spanish version of the FAB questionnaire. Spine 31:104–110PubMedCrossRef

22.

Pfingstein M, Kröner-Herwig B, Leibning E, Kroshage U, Hildebrandt J (2000) Validation of the German version of the Fear Avoidance Beliefs Questionnaire (FABQ). Eur J Pain 4:259–266CrossRef

23.

Chaory K, Fayad F, Rannou F, Fermanian J, Revel M, Poiraudeau S (2004) Validation of the French version of the Fear Avoidance Beliefs Questionnaire (FABQ). Spine 14:908–913CrossRef

24.

Rainville J, Carlson N, Polatin P, Gatchel RJ, Indahl A (2000) Exploration of physicians’ recommendations for activities in chronic low back pain. Spine 25:2210–2220PubMedCrossRef

25.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428PubMedCrossRef

26.

Cohen J (1988) Statistical power analysis for the behavioral sciences. Erlbaun Associates, Hillsdale

27.

Pett MA, Lackey NR, Sullivan JJ (2003) Making sense of factor analysis. the use of factor analysis for instrument development in health care research. Sage Publications, Thousand Oaks

28.

Bishop A, Thomas E, Foster NE (2007) Health care practitioners attitudes and beliefs about low back pain: a systematic search and critical review of available measurement tools. Pain 132:91–101PubMedCrossRef

29.

Chen G, Tan BK, Jia HL, O’Sullivan P, Burnett A (2011) Questionnaires to examine back pain beliefs held by health care professionals: a psychometric evaluation of simplified Chinese versions. Spine 36:1505–1511PubMedCrossRef

30.

Sanders SH, Brena SF, Spier CJ, Beltrutti D, McConnell H, Quintero O (1992) Chronic low back pain patients around the world: cross cultural similarities and differences. Clin J Pain 8:317–323PubMedCrossRef

31.

Pincus T, Santos R, Breen A, Burton AK, Underwood M (2008) A review and proposal for a core set of factors for prospective cohorts in low back pain. A consensus statement. Arthr Rheum 59:14–24CrossRef

32.

Nyland LJ, Grimmer KA (2003) Is undergraduate physiotherapy study a risk factor for low back pain? A prevalence study in physiotherapy students. BMC Musculoeskelet Disord 4:22. doi:10.1186/1471-2474-4-22 CrossRef

33.

Domenech J, Sánchez-Zuriaga D, Segura-Ortí E, Espejo-Tort B, Lisón JF (2011) Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: a randomised clinical trial. Pain 152:2557–2563PubMedCrossRef

34.

Adams AS, Soumerai SB, Lomas J, Ross-Degnan D (1999) Evidence of self-report bias in assessing adherence to guidelines. Int J Qual Health Care 11:187–192PubMedCrossRef

35.

Peabody JW, Luck J, Glassman P, Dresselhaus TR, Lee M (2000) Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA 283:1715–1722PubMedCrossRef

36.

Peabody JW, Luck J, Glassman P, Jain S, Hansen J, Spell M, Lee M (2004) Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med 141:771–780PubMedCrossRef

37.

Veloski J, Tai S, Evans AS, Nash DB (2005) Clinical vignette-based surveys: a tool for assessing physician practice variation. Am J Med Qual 20:151–157PubMedCrossRef

38.

Baker FB (1985) The basics of item response theory. Heinemann, Portsmouth

Title: Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire
Authors: Julio Domenech
Eva Segura-Ortí
Juan Francisco Lisón
Begoña Espejo-Tort
Daniel Sánchez-Zuriaga
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 5/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2604-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2013

Reliability and validity study on the Hungarian versions of the Oswestry Disability Index and the Quebec Back Pain Disability Scale

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

Letter to the Editor concerning “Far lateral approaches (XLIF) in adult scoliosis” by P. Berjano and C. Lamartina (Eur Spine J. 2012 Jul 27. [Epub ahead of print])

The clinical and radiological outcomes of multilevel minimally invasive transforaminal lumbar interbody fusion

The high-risk discectomy patient: prevention of reherniation in patients with large anular defects using an anular closure device

Editor-in-Chief, European Spine Journal: call for nominations and applications