title: The development and exploratory analysis of the Back Pain Attitudes Questionnaire (Back-PAQ).
abstract: OBJECTIVE
  To develop an instrument to assess attitudes and underlying beliefs about back pain, and subsequently investigate its internal consistency and underlying structures.
  
  
  METHODS
  The instrument was developed by a multidisciplinary team of clinicians and researchers based on analysis of qualitative interviews with people experiencing acute and chronic back pain. Exploratory analysis was conducted using data from a population-based cross-sectional survey.
  
  
  METHODS
  Qualitative interviews with community-based participants and subsequent postal survey.
  
  
  METHODS
  Instrument development informed by interviews with 12 participants with acute back pain and 11 participants with chronic back pain. Data for exploratory analysis collected from New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. 602 valid responses were received.
  
  
  METHODS
  The 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed. Internal consistency was evaluated by the Cronbach α coefficient. Exploratory analysis investigated the structure of the data using Principal Component Analysis.
  
  
  RESULTS
  The 34-item long form of the scale had acceptable internal consistency (α=0.70; 95% CI 0.66 to 0.73). Exploratory analysis identified five two-item principal components which accounted for 74% of the variance in the reduced data set: 'vulnerability of the back'; 'relationship between back pain and injury'; 'activity participation while experiencing back pain'; 'prognosis of back pain' and 'psychological influences on recovery'. Internal consistency was acceptable for the reduced 10-item scale (α=0.61; 95% CI 0.56 to 0.66) and the identified components (α between 0.50 and 0.78).
  
  
  CONCLUSIONS
  The 34-item long form of the scale may be appropriate for use in future cross-sectional studies. The 10-item short form may be appropriate for use as a screening tool, or an outcome assessment instrument. Further testing of the 10-item Back-PAQ's construct validity, reliability, responsiveness to change and predictive ability needs to be conducted.
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
authors.forename: Ben
authors.initials: B
authors.lastname: Darlow
authors.affiliation: Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors.forename: Meredith
authors.initials: M
authors.lastname: Perry
authors.affiliation: Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
authors.forename: Fiona
authors.initials: F
authors.lastname: Mathieson
authors.affiliation: Biostatistical Group, University of Otago, Wellington, New Zealand.
authors.forename: James
authors.initials: J
authors.lastname: Stanley
authors.affiliation: Centre for Health Sciences, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Melloh
authors.affiliation: Gillies McIndoe Research Institute, Newtown, Wellington South, New Zealand.
authors.forename: Reginald
authors.initials: R
authors.lastname: Marsh
authors.affiliation: Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors.forename: G David
authors.initials: GD
authors.lastname: Baxter
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dowell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement / Q000379:methods*; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Epidemiology; Pain Management; Primary Care