title: Development and validation of a questionnaire categorizing behavioral strategies in patients with chronic low back pain.
abstract: OBJECTIVE
  The identification of helpful or unhelpful behavioral strategies for coping with pain would assist in optimizing the management of patients with chronic low back pain (CLBP). The objective was to develop and validate a questionnaire for categorizing behavioral strategies in patients with nonspecific CLBP.
  
  
  METHODS
  (1) Development of a preliminary questionnaire based on a qualitative study in 25 patients with CLBP; (2) Item reduction and questionnaire validation by a multicenter international prospective study in patients with CLBP, with multiple correspondence analysis to identify behavioral profiles, whose characteristics and internal and external validities were assessed; 12-month study of treatments in 58 patients; (3) Evaluation of reproducibility in 30 patients.
  
  
  RESULTS
  (1) The preliminary questionnaire had 87 items in eight pain-coping domains. (2) Three behavioral profiles were identified: effective coping, emotional distress, and kinesiophobia. The questionnaire was reduced to 21 items in seven domains. Cronbach's α indicated moderate internal consistency (0.47-0.66). External validity versus anxiety, depression, and coping strategies was good. As expected, functional restoration program was used more often by patients with kinesiophobia than by those with effective coping (50% vs. 25%, P<0.05). (3) Reproducibility was good (κ=0.70).
  
  
  CONCLUSIONS
  This new, simple questionnaire allows the identification of three behavioral profiles, thus guiding the development of personalized management programs for NCLBP.
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC Université Paris 06, 75013 Paris, France. Electronic address: florian.bailly@aphp.fr.
authors.forename: Florian
authors.initials: F
authors.lastname: Bailly
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC Université Paris 06, 75013 Paris, France.
authors.forename: Violaine
authors.initials: V
authors.lastname: Foltz
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC Université Paris 06, 75013 Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Rozenberg
authors.affiliation: Service MPR, CHU vaudois, 1011 Lausanne, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Norberg
authors.affiliation: Centre hospitalier de Nantes, 44093 Nantes, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Glemarec
authors.affiliation: Centre hospitalier Charles-Nicolle, 76000 Rouen, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Banneville
authors.affiliation: Département des sciences de la motricité, université de Liège, 4000 Liège, Belgium; Service de l'appareil locomoteur, CHU de Liège, 4000 Liège, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Demoulin
authors.affiliation: Service de rhumatologie B, hôpital Cochin, AP-HP, 75014 Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Gaud-Listrat
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC Université Paris 06, 75013 Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne universités, UPMC Université Paris 06, 75013 Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000503:physiopathology / Q000628:therapy*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D015438:Health Behavior / Q000502:physiology*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D012803:Sick Role; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Adjustment strategy; Behavior; Coping; Low back pain; Management; Pain management; Questionnaire