nach oben

Journal of Occupational Rehabilitation

Erschienen in:

01.03.2012

Validity and Reliability of the Fear-Avoidance Beliefs Questionnaire (FABQ) in Workers with Upper Extremity Injuries

verfasst von: Taucha Inrig, Bev Amey, Cheryl Borthwick, Dorcas Beaton

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Introduction Fear Avoidance Beliefs (FAB) have been associated with increased pain, dysfunction and difficulty returning to work in Upper Extremity (UE) injures. The FABQ is used to assess FAB, but its measurement properties have not been established in UE. The purpose of this study is to evaluate the reliability and validity of the FABQ to screen UE compensated injured workers for FAB. Methods Consenting workers attending a specialty clinic completed a modified FABQ, QuickDASH (Disability), SPADI Pain Score and von Korff Chronic Pain Grade (Pain), SF-36v2 (General Health), and Work Instability Scale (Job Instability). A sub-sample of workers (n = 48) completed the FABQ 2 weeks later for test–retest reliability. Results 187 workers; 54.0% male; mean age 45.2 (sd 9.68); 56% were currently working. Mean subscale scores (FABQ-Work [FABQ-W]/FABQ-Physical Activity [FABQ-PA]) were 35/42 and 20/24. Ceiling effects (23%/38%) existed in both subscales. Cronbach’s alphas were 0.75/0.78. Test–retest analysis (ICC(2,1)) was lower than desired (0.52/0.59). Construct validation was supported by a moderate correlation between FABQ-W/FABQ-PA and QuickDASH Work Module (0.51/0.42) and WIS (0.46/0.38) in those currently working. Low correlations were found between the subscales measures of pain (SPADI: 0.24/0.23; Chronic Pain Grade: 0.25/0.25), and SF-36 MCS (−0.25/−0.30). Conclusions Although FAB is an important concept to measure in compensated UE injured workers, the FABQ had limitations in this population as there was a high ceiling effect, and lower than desired reliability for individual discrimination. A priori hypotheses around construct validity were rejected for 16/22 concepts tested.

Slade PD, Troup JD, Lethem J, Bentley G. The fear-avoidance model of exaggerated pain perception—II. Behav Res Ther. 1983;21(4):409–16.PubMedCrossRef

Lethem J, Slade PD, Troup JD, Bentley G. Outline of a fear-avoidance model of exaggerated pain perception—I. Behav Res Ther. 1983;21(4):401–8.PubMedCrossRef

Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52(2):157–68.PubMedCrossRef

Crombez G, Vlaeyen JW, Heuts PH, Lysens R. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1–2):329–39.PubMedCrossRef

Boersma K, Linton SJ. Psychological processes underlying the development of a chronic pain problem: a prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability. Clin J Pain. 2006;22(2):160–6.PubMedCrossRef

Fritz JM, George SZ, Delitto A. The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status. Pain. 2001;94(1):7–15.PubMedCrossRef

Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30(1):77–94.PubMedCrossRef

Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32.PubMedCrossRef

Ciccone DS, Just N. Pain expectancy and work disability in patients with acute and chronic pain: a test of the fear avoidance hypothesis. J Pain. 2001;2(3):181–94.PubMedCrossRef

10.

Cleland JA, Fritz JM, Brennan GP. Predictive validity of initial fear avoidance beliefs in patients with low back pain receiving physical therapy: is the FABQ a useful screening tool for identifying patients at risk for a poor recovery? Eur Spine J. 2008;17(1):70–9.PubMedCrossRef

11.

Fritz JM, George SZ. Identifying psychosocial variables in patients with acute work-related low back pain: the importance of fear-avoidance beliefs. Phys Ther. 2002;82(10):973–83.PubMed

12.

George SZ, Fritz JM, Erhard RE. A comparison of fear-avoidance beliefs in patients with lumbar spine pain and cervical spine pain. Spine. 2001;26(19):2139–45.PubMedCrossRef

13.

Grotle M, Vollestad NK, Veierod MB, Brox JI. Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain. Pain. 2004;112(3):343–52.PubMedCrossRef

14.

Lotters F, Franche RL, Hogg-Johnson S, Burdorf A, Pole JD. The prognostic value of depressive symptoms, fear-avoidance, and self-efficacy for duration of lost-time benefits in workers with musculoskeletal disorders. Occup Environ Med. 2006;63(12):794–801.PubMedCrossRef

15.

Vowles KE, Gross RT. Work-related beliefs about injury and physical capability for work in individuals with chronic pain. Pain. 2003;101(3):291–8.PubMedCrossRef

16.

Pfingsten M, Kroner-Herwig B, Leibing E, Kronshage U, Hildebrandt J. Validation of the German version of the fear-avoidance beliefs questionnaire (FABQ). Eur J Pain. 2000;4(3):259–66.PubMedCrossRef

17.

Coudeyre E, Tubach F, Rannou F, Baron G, Coriat F, Brin S, et al. Fear-avoidance beliefs about back pain in patients with acute LBP. Clin J Pain. 2007;23(8):720–5.PubMedCrossRef

18.

Georgoudis G, Papathanasiou G, Spiropoulos P, Katsoulakis K. Cognitive assessment of musculoskeletal pain with a newly validated Greek version of the fear-avoidance beliefs questionnaire (FABQ). Eur J Pain. 2007;11(3):341–51.PubMedCrossRef

19.

Grotle M, Brox JI, Vollestad NK. Reliability, validity and responsiveness of the fear-avoidance beliefs questionnaire: methodological aspects of the Norwegian version. J Rehabil Med. 2006;38(6):346–53.PubMedCrossRef

20.

Lee KC, Chiu TT, Lam TH. Psychometric properties of the fear-avoidance beliefs questionnaire in patients with neck pain. Clin Rehabil. 2006;20(10):909–20.PubMed

21.

Staerkle R, Mannion AF, Elfering A, Junge A, Semmer NK, Jacobshagen N, et al. Longitudinal validation of the fear-avoidance beliefs questionnaire (FABQ) in a Swiss-German sample of low back pain patients. Eur Spine J. 2004;13(4):332–40.PubMedCrossRef

22.

Kovacs FM, Muriel A, Medina JM, Abraira V, Sanchez MD, Jauregui JO, et al. Psychometric characteristics of the Spanish version of the FAB questionnaire. Spine. 2006;31(1):104–10.PubMedCrossRef

23.

Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.PubMedCrossRef

24.

McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4(4):293–307.PubMedCrossRef

25.

Nunnally JC. Assessment of reliability. Psychometric theory. 2nd ed. New York: McGraw-Hill Book Co.; 1978. p. 225–55.

26.

Williamson E. Fear avoidance beliefs questionnaire (FABQ). Aust J Physiother. 2006;52(2):149.PubMedCrossRef

27.

Burton AK, Waddell G, Tillotson KM, Summerton N. Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care. Spine. 1999;24(23):2484–91.PubMedCrossRef

28.

George SZ, Bialosky JE, Fritz JM. Physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs. Phys Ther. 2004;84(6):538–49.PubMed

29.

Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthr Care Res. 1991;4(4):143–9.CrossRef

30.

Heald SL, Riddle DL, Lamb RL. The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure. Phys Ther. 1997;77(10):1079–89.PubMed

31.

Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain. 1992;50(2):133–49.CrossRef

32.

Beaton DE, Wright JG, Katz JN, Upper E. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am Vol. 2005;87(5):1038–46.CrossRef

33.

Ware JEJ. SF-36 health survey update. [Review] [73 refs]. Spine. 2000;25(24):3130–9.PubMedCrossRef

34.

Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthr Rheum. 2003;49(2):156–63.CrossRef

35.

Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, et al. Development of a work instability scale for rheumatoid arthritis. Arthr Rheum. 2003;49(3):349–54.CrossRef

36.

Human Resources and Social Development Department Canada. National occupational classification matrix 2006. http://www5.hrsdc.gc.ca/noc/english/noc/2006/welcome.aspx (2006). Accessed 20 April 2011.

37.

Shrout PE, Fleiss J. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.PubMedCrossRef

38.

Boersma K, Linton SJ. Screening to identify patients at risk: profiles of psychological risk factors for early intervention. Clin J Pain. 2005;21(1):38–43.PubMedCrossRef

39.

George SZ, Cere A, Zeppieri G, Cere M, Borut M, Hodges M, et al. Behavioral interventions for sub-acute low back pain… 2008 combined sections meeting…Nashville, Tennessee, February 6–9, 2008. J Orthop Sports Phys Ther. 2008;1(Suppl):2.

40.

Cleland JA, Fritz JM, Childs JD. Psychometric properties of the fear-avoidance beliefs questionnaire and Tampa scale of Kinesiophobia in patients with neck pain. Am J Phys Med Rehabil. 2008;87(2):109–17.PubMedCrossRef

41.

van Vuuren BJ, van Heerden HJ, Becker PJ, Zinzen E, Meeusen R. Fear-avoidance beliefs and pain coping strategies in relation to lower back problems in a South African steel industry. Eur J Pain. 2006;10(3):233–9.PubMedCrossRef

42.

Swinkels-Meewisse IE, Roelofs J, Verbeek AL, Oostendorp RA, Vlaeyen JW. Fear-avoidance beliefs, disability, and participation in workers and non-workers with acute low back pain. Clin J Pain. 2006;22(1):45–54.PubMedCrossRef

43.

Storheim K, Brox JI, Holm I, Bo K. Predictors of return to work in patients sick listed for sub-acute low back pain: a 12-month follow-up study. J Rehabil Med. 2005;37(6):365–71.PubMedCrossRef

44.

Kovacs FM, Muriel A, Abriaira V, Medina JM, Castillo S, Olabe J, et al. The influence of fear avoidance beliefs on disability and quality of life is sparse in Spanish low back pain patients. Spine. 2005;30(22):E676–82.PubMedCrossRef

45.

Staal JB, Hlobil H, Koke AJA, Twisk JWR, Smid T, van MW. Graded activity for workers with low back pain: who benefits most and how does it work? Arthr Rheum (Arthr Care Res) 2008;(5):642–9.

46.

van Vuuren B, Zinzen E, van Heerden HJ, Becker P, Meeusen R. Psychosocial factors related to lower back problems in a South African manganese industry. J Occup Rehabil. 2005;15(2):215–25.PubMedCrossRef

47.

Godges JJ, Anger MA, Zimmerman G, Delitto A. Effects of education on return-to-work status for people with fear-avoidance beliefs and acute low back pain. Phys Ther. 2008;88(2):231–9.PubMedCrossRef

48.

Voerman GE, Sandsjo L, Vollenbroek-Hutten MM, Larsman P, Kadefors R, Hermens HJ. Changes in cognitive-behavioral factors and muscle activation patterns after interventions for work-related neck-shoulder complaints: relations with discomfort and disability. J Occup Rehabil. 2007;17(4):593–609.PubMedCrossRef

49.

Lee KC, Chiu TT, Lam TH. The role of fear-avoidance beliefs in patients with neck pain: relationships with current and future disability and work capacity. Clin Rehabil. 2007;31(9):812–21.CrossRef

50.

Kovacs FM, Muriel A, Castillo S, Medina JM, Royuela A. Spanish back pain research network. Fear avoidance beliefs influence duration of sick leave in Spanish low back pain patients. Spine. 2007;32(16):1761–6.PubMedCrossRef

Titel: Validity and Reliability of the Fear-Avoidance Beliefs Questionnaire (FABQ) in Workers with Upper Extremity Injuries
verfasst von: Taucha Inrig
Bev Amey
Cheryl Borthwick
Dorcas Beaton
Publikationsdatum: 01.03.2012
Verlag: Springer US
Erschienen in: Journal of Occupational Rehabilitation / Ausgabe 1/2012
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-011-9323-3

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2012

Work-Related Primary Care in Occupational Health Physician’s Practice

The ‘Ability’ Paradigm in Vocational Rehabilitation: Challenges in an Ontario Injured Worker Retraining Program

Education and Benchmarking Among Physicians May Facilitate Sick-Listing Practice

Readiness for Change Predicts Outcomes of Functional Rehabilitation Following Motor Vehicle Accident

Injured Workers’ Construction of Expectations of Return to Work with Sub-Acute Back Pain: The Role of Perceived Uncertainty

Return to Work Expectations of Workers on Long-Term Non-Work-Related Sick Leave