title: The Italian version of the Fear-Avoidance Beliefs Questionnaire (FABQ-I): cross-cultural adaptation, factor analysis, reliability, validity, and sensitivity to change.
abstract: METHODS
  Evaluation of the psychometric properties of a translated and culturally adapted questionnaire.
  
  
  OBJECTIVE
  Translating, culturally adapting, and validating the Italian version of the Fear-Avoidance Beliefs Questionnaire (FABQ-I) to allow its use with Italian-speaking patients with low-back pain (LBP).
  
  
  BACKGROUND
  Growing attention is being given to standardized outcome measures to improve interventions for LBP. A translated form of the FABQ has never been validated in Italian patients with LBP.
  
  
  METHODS
  The FABQ-I questionnaire was developed by means of forward-backward translation, a final review by an expert committee, and a test of the prefinal version to establish its correspondence with the original English version. The psychometric testing included factor analysis, reliability by internal consistency (Cronbach α) and test-retest reliability (intraclass coefficient correlation), convergent validity by comparing FABQ-I with the Italian version of the Tampa Scale of Kinesiophobia (TSK-I), and discriminant validity by comparing FABQ-I with a visual analogue scale, the Roland Morris Disability Questionnaire, and the Hospital Anxiety and Depression Scale (Pearson correlation).
  
  
  RESULTS
  It took 4 months to develop a shared version of the FABQ-I. The questionnaire was administered to 180 subjects and proved to be acceptable. Factor analysis revealed a 2-factor, 12-item solution (57% of explained variance). The questionnaire showed good internal consistency (α = 0.822) and high test-retest reliability (intraclass coefficient correlation = 0.869). Convergent validity showed a moderate correlation with TSK-I (r = 0.440), and discriminant validity showed moderate-poor correlations with a visual analogue scale (r = 0.335), Roland Morris Disability Questionnaire (r = 0.414), and Hospital Anxiety and Depression Scale (r = 0.258 for the Anxiety score and r = 0.246 for the Depression score). The results of the psychometric analyses of the subscales were similar to those of the scale as a whole.
  
  
  CONCLUSIONS
  The FABQ outcome measure was successfully translated into Italian and proved to have a good factorial structure and psychometric properties that replicated the results of other existing versions. Its use is recommended for research purposes.
authors.affiliation: Physical Medicine and Rehabilitation Unit, Salvatore Maugeri Foundation Institute of Care and Research (IRCCS), Milan, Italy. marco.monticone@fsm.it
authors.forename: Marco
authors.initials: M
authors.lastname: Monticone
authors.forename: Paola
authors.initials: P
authors.lastname: Baiardi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonetti
authors.forename: Silvano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Calogero
authors.initials: C
authors.lastname: Foti
authors.forename: Paolo
authors.initials: P
authors.lastname: Pillastrini
authors.forename: Barbara
authors.initials: B
authors.lastname: Rocca
authors.forename: Carla
authors.initials: C
authors.lastname: Vanti
authors.forename: Gustavo
authors.initials: G
authors.lastname: Zanoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007558:Italy; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires