Dima Alexandra, Lewith George T, Little Paul, Moss-Morris Rona, Foster Nadine E, Hankins Matthew, Surtees George, Bishop Felicity L
Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Southampton, United Kingdom Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom Real-World Evidence Solutions, IMS Health, London, United Kingdom Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, the Netherlands Centre for Applications of Health Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, United Kingdom.
Pain. 2015 Aug;156(8):1489-1500. doi: 10.1097/j.pain.0000000000000193.
Choosing the most appropriate treatment for individual patients with low back pain (LBP) can be challenging, and clinical guidelines recommend taking into account patients' preferences. However, no tools exist to assess or compare patients' views about LBP treatments. We report the development and validation of the Low Back Pain Treatment Beliefs Questionnaire (LBP-TBQ) for use across different treatments in clinical practice and research. Using qualitative data, we developed a pool of items assessing perceived credibility, effectiveness, concerns about, and individual "fit" of specific treatments. These items were included in a survey completed by 429 primary care patients with LBP, of whom 115 completed it again 1 to 2 weeks later. We performed psychometric analyses using nonparametric item response theory and classical test theory. The 4 subscales of the resulting 16-item LBP-TBQ showed good homogeneity (H = 0.46-0.76), internal consistency (α = 0.73-0.94), and stability (r = 0.63-0.83), confirmed most convergent and discriminant validity hypotheses, and had acceptable structural validity for 4 guideline-recommended treatments: pain medication, exercise, manual therapy, and acupuncture. Participants with stronger positive treatment beliefs were more likely to rank that treatment as their first choice, indicating good criterion validity (t values = 3.11-9.80, all P < 0.01, except pain medication effectiveness beliefs, t(339) = 1.35; P = 0.18). A short 4-item version also displayed good homogeneity (H = 0.43-0.66), internal consistency (α = 0.70-0.86), and stability (r = 0.82-0.85) and was significantly related to treatment choice (t values = 4.33-9.25, all P < 0.01). The LBP-TBQ can be used to assess treatment beliefs in primary care patients with LBP and to investigate the effects of treatment beliefs on treatment uptake and adherence.
为患有腰痛（LBP）的个体患者选择最合适的治疗方法可能具有挑战性，临床指南建议考虑患者的偏好。然而，目前尚无工具可用于评估或比较患者对腰痛治疗的看法。我们报告了腰痛治疗信念问卷（LBP-TBQ）的开发和验证情况，该问卷可用于临床实践和研究中的不同治疗方法。利用定性数据，我们编制了一组项目，用于评估特定治疗方法的可信度、有效性、相关担忧以及个体“适配性”。这些项目包含在一项由429名患有腰痛的初级保健患者完成的调查中，其中115名患者在1至2周后再次完成了该调查。我们使用非参数项目反应理论和经典测试理论进行了心理测量分析。最终得到的包含16个项目的LBP-TBQ的4个分量表显示出良好的同质性（H = 0.46 - 0.76）、内部一致性（α = 0.73 - 0.94）和稳定性（r = 0.63 - 0.83），证实了大多数收敛效度和区分效度假设，并且对于4种指南推荐的治疗方法：止痛药物、运动、手法治疗和针灸，具有可接受的结构效度。具有更强积极治疗信念的参与者更有可能将该治疗方法列为首选，表明具有良好的效标效度（t值 = 3.11 - 9.80，除止痛药物有效性信念外，所有P < 0.01，t(339) = 1.35；P = 0.18）。一个简短的包含4个项目的版本也显示出良好的同质性（H = 0.43 - 0.66）、内部一致性（α = 0.70 - 0.86）和稳定性（r = 0.82 - 0.85），并且与治疗选择显著相关（t值 = 4.33 - 9.25，所有P < 0.01）。LBP-TBQ可用于评估初级保健腰痛患者的治疗信念，并研究治疗信念对治疗接受度和依从性的影响。
