Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
Spine (Phila Pa 1976). 2020 Jan 15;45(2):134-140. doi: 10.1097/BRS.0000000000003188.
A cohort study with 12 months of follow-up.
To assess (1) the unidimensionality of the Fear-Avoidance Beliefs Questionnaire (FABQ) and (2) whether single questions in the FABQ predict future sickness absence as well as the whole scale.
The fear-avoidance model is a leading model in describing the link between musculoskeletal pain and chronic disability. However, reported measurement properties have been inconsistent regarding the FABQ.
Individuals (n = 722) sick listed due to musculoskeletal, unspecified or common mental health disorders undergoing rehabilitation was included. A Rasch analysis was applied to evaluate the measurement properties of FABQ and its two subscales (physical activity and work). Linear regression was used to assess how well single items predicted future sickness absence.
The Rasch analysis did not support the FABQ or its two subscales representing a unidimensional construct. The 7-point scoring of the items was far too fine meshed and in the present population the data only supported a yes or no or a 3-point response option. The items were invariant to age, whereas two of the items revealed sex differences. The item "I do not think that I will be back to my normal work within 3 months" was the best predictor of future sickness absence. Adding the item "I should not do my regular work with my present pain" improved the prediction model slightly.
The FABQ is not a good measure of fear-avoidance beliefs about work or physical activity, and the predictive property of the FABQ questionnaire is most likely related to expectations rather than fear. Based on these results we do not recommend using the FABQ to measure fear-avoidance beliefs.
一项具有 12 个月随访的队列研究。
评估（1）害怕-回避信念问卷（FABQ）的单维性，以及（2）FABQ 的单项问题是否能像整个量表一样预测未来的病假。
恐惧-回避模型是描述肌肉骨骼疼痛与慢性残疾之间关系的主要模型。然而，关于 FABQ 的报告测量特性一直不一致。
纳入了因肌肉骨骼、未指定或常见心理健康障碍而请病假接受康复治疗的患者（n=722）。应用 Rasch 分析评估 FABQ 及其两个子量表（体力活动和工作）的测量特性。线性回归用于评估单项问题预测未来病假的程度。
Rasch 分析不支持 FABQ 或其两个子量表代表单一维度结构。项目的 7 点评分过于精细，在当前人群中，数据仅支持是或否或 3 点的应答选项。项目在年龄方面是不变的，而其中两个项目显示出性别差异。项目“我不认为我在 3 个月内会恢复正常工作”是预测未来病假的最佳指标。添加项目“我不应该在目前的疼痛下做我的常规工作”略微改善了预测模型。
FABQ 不是衡量对工作或体力活动的恐惧-回避信念的良好指标，FABQ 问卷的预测特性很可能与预期而不是恐惧有关。基于这些结果，我们不建议使用 FABQ 来测量恐惧-回避信念。
