Department of Psychiatry, The University of Melbourne, Australia.
Clin J Pain. 2013 Mar;29(3):245-52. doi: 10.1097/AJP.0b013e31824b3aed.
Low back pain (LBP) is common, and social isolation is both a risk factor for poor recovery and a consequence. However, no studies seem to have validated social isolation measures in LBP populations.
This study assessed the validity of the Friendship Scale (FS), a brief measure of social isolation.
LBP participants were 100 consecutive consenting adult patients attending physiotherapy outpatient clinics, matched (1:2) by age and gender with a general population sample (GPS; n=200). FS validation was through factor analysis, internal consistency, sensitivity by known groups, and Rasch analysis.
: There were significant differences between LPB and GPS on 5 of the 6 FS items. Social isolation on the FS was reported by 26% of the LBP cohort compared with 9% of the GPS. All FS items loaded on the principal component >0.60, suggesting unidimensionality. Internal consistency was α=0.81. The FS was sensitive by pain severity and study cohort. Rasch analysis showed no disordered items, although 2 items were marginally misfitting. Differential item functioning by sex was observed on 1 item; there was no other observed differential item functioning. After removal of the worst fitting item (feeling alone), the remaining items fit the Rasch model. This, however, may have been a function of study samples.
Generally, the FS performed well, and its descriptive system contains excess capacity beyond that needed in the study population; that is, those with LBP were not particularly socially isolated, and responses indicating severe social isolation were barely reported by these participants. Overall, the FS appears to be a suitable instrument for assessing social isolation among LBP patients.
下背痛（LBP）很常见，社会隔离既是恢复不良的风险因素，也是其后果。然而，似乎没有研究验证过 LBP 人群中社会隔离的测量方法。
本研究评估了社交孤立量表（FS）的有效性，这是一种衡量社交孤立的简短方法。
LBP 参与者为 100 名连续同意参加物理治疗门诊的成年患者，按年龄和性别与一般人群样本（GPS；n=200）匹配（1:2）。FS 的验证是通过因子分析、内部一致性、已知群体的敏感性和 Rasch 分析进行的。
在 FS 的 6 个项目中，LBP 和 GPS 之间有 5 个项目存在显著差异。与 GPS 的 9%相比，FS 报告的 LBP 队列中有 26%存在社交孤立。FS 的所有项目在主成分上的负荷>0.60，表明具有单一维度。内部一致性为α=0.81。FS 对疼痛严重程度和研究队列敏感。Rasch 分析显示没有无序项目，尽管有 2 个项目略有拟合不良。在 1 个项目上观察到性别差异的项目功能，但没有观察到其他差异的项目功能。在去除拟合最差的项目（感到孤独）后，剩余的项目符合 Rasch 模型。然而，这可能是研究样本的功能。
总体而言，FS 表现良好，其描述性系统具有研究人群所需的额外能力；也就是说，那些患有 LBP 的人并没有特别孤立，而那些报告严重社会隔离的人在这些参与者中几乎没有报告。总的来说，FS 似乎是一种适合评估 LBP 患者社会隔离的工具。
