Validation of the French version of the fear avoidance belief questionnaire.
METHODS
Observational prospective study.


OBJECTIVE
To assess the reliability, validity, and responsiveness of the French version of the Fear Avoidance Belief Questionnaire.


BACKGROUND
Fear, avoidance attitudes, and belief play pivotal roles in disability perceived by patients with chronic low back pain. The Fear Avoidance Belief Questionnaire is a two-part questionnaire assessing fear, avoidance, and beliefs about professional activity and physical activity.


METHODS
The Fear Avoidance Belief Questionnaire was translated by use of the forward and backward translation procedure. Test-retest reliability was assessed in 31 patients (Group 1) with the intraclass correlation coefficient and the Bland and Altman method. Construct validity was assessed in two groups of patients (Group 2, n = 147; Group 3, n = 70) with the Spearman rank correlation coefficient and factor analysis. Responsiveness was assessed in Group 3, after they underwent a functional restoration program, by the effect size and the standardized response mean.


RESULTS
Test-retest reliability was good, with an intra-class correlation coefficient value of 0.88 and 0.72 for fear, avoidance, and beliefs about professional activity and physical activity, respectively. Use of the Bland and Altman method produced a homogeneous distribution of the differences, with no systematic trend observed. The expected divergent validity was observed in Groups 2 and 3. Factor analysis extracted four factors in Group 2 and the two original factors of the English Fear Avoidance Belief Questionnaire in Group 3. The lowest effect size and standardized response mean values (0.30 and 0.31, respectively) were observed with the fear, avoidance, and beliefs about professional activity.


CONCLUSIONS
The psychometric properties (test-retest reliability, construct validity, and responsiveness) of the French version of the Fear Avoidance Belief Questionnaire are acceptable, and fear, avoidance, and belief can now be assessed in French-speaking patients with low back pain.
Chaory
Karl
K
Department of Physical and Rehabilitation Medicine, Hopital Cochin, AP-HP, Université René Descartes, Paris, France.
Fayad
Fouad
F
Rannou
François
F
Lefèvre-Colau
Marie-Martine
MM
Fermanian
Jacques
J
Revel
Michel
M
Poiraudeau
Serge
S
D000223:Adaptation, Psychological; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005602:France; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*