title: Longitudinal validation of the fear-avoidance beliefs questionnaire (FABQ) in a Swiss-German sample of low back pain patients.
abstract: Work and activity-specific fear-avoidance beliefs have been identified as important predictor variables in relation to the development of, and treatment outcome for, chronic low back pain. The objective of this study was to provide a cross-cultural German adaptation of the Fear-Avoidance Beliefs Questionnaire (FABQ) and to investigate its psychometric properties (reliability, validity) and predictive power in a sample of Swiss-German low back pain patients. Questionnaires from 388 operatively and non-operatively treated patients were administered before and 6 months after treatment to assess: socio-demographic data, disability (Roland and Morris), pain severity, fear-avoidance beliefs, depression (ZUNG) and heightened somatic awareness (MSPQ). Complete baseline and follow-up questionnaires were available from 255 participants. The corrected item-total correlations, coefficients of test-retest reliability and internal consistencies of the two scales of the questionnaire were highly satisfactory. In a confirmatory factor analysis (CFA), all items loaded on the appropriate factor with minor loadings on the other. Cross-sectional regression analysis with disability and work loss as the dependent variables yielded results that were highly comparable with those reported for the original version. Prognostic regression analysis replicated the findings for work loss. The cross-cultural German adaptation of the FABQ was very successful and yielded psychometric properties and predictive power of the scales similar to the original version. The inclusion of fear-avoidance beliefs as predictor variables in studies of low back pain is highly recommended, as they appear to have unique predictive power in analyses of disability and work loss.
authors.affiliation: Center for Spinal Surgery, University of Zurich, Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland.
authors.forename: Ralph
authors.initials: R
authors.lastname: Staerkle
authors.forename: Anne F
authors.initials: AF
authors.lastname: Mannion
authors.forename: Achim
authors.initials: A
authors.lastname: Elfering
authors.forename: Astrid
authors.initials: A
authors.lastname: Junge
authors.forename: Norbert K
authors.initials: NK
authors.lastname: Semmer
authors.forename: Nicola
authors.initials: N
authors.lastname: Jacobshagen
authors.forename: Dieter
authors.initials: D
authors.lastname: Grob
authors.forename: Jiri
authors.initials: J
authors.lastname: Dvorak
authors.forename: Norbert
authors.initials: N
authors.lastname: Boos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D005858:Germany; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018582:Sick Leave; D011795:Surveys and Questionnaires / Q000592:standards*; D013557:Switzerland