Department of Psychology, York University, Toronto, Canada.
Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada.
Eur J Pain. 2020 Nov;24(10):1999-2014. doi: 10.1002/ejp.1643. Epub 2020 Sep 22.
The objective of this study was to evaluate the psychometric properties of the 17-item Tampa Scale for Kinesiophobia (TSK) in youth.
Participants were 264 children and adolescents (58.7% female, M = 14.1 years, SD = 2.51) scheduled for major surgery who were assessed before surgery, while in hospital postoperatively, and at 6 and 12 months after surgery. Exploratory factor analyses (EFA) were conducted to determine the factor structure of pre-operative TSK scores. Reliability, and convergent, discriminant, and predictive validity were examined.
EFA on the 17-item TSK revealed a two-factor model distinguishing the 13 positively scored items from the 4 reverse scored items, but the fit was poor. A second EFA was conducted on the 13 positively scored items (TSK-13) revealing a three-factor model: Fear of injury, bodily vulnerability, and activity avoidance. The TSK-13 showed adequate internal consistency (Ω = 0.82) and weak convergent validity. The TSK-13 was not correlated with postoperative, in-hospital physical activity (actigraphy; r (179) = -0.10, p = 0.18) and showed adequate discriminant validity, that is correlations less than 0.70, with measures of depression (r (225) = 0.41, p < 0.001) and general anxiety (r (224)=0.35, p < 0.001). Predictive validity for pain-related disability at 12 months (r (70) = 0.34, p < 0.001) was adequate.
The original TSK-17 does not appear to be a meaningful measure of kinesiophobia in youth after surgery possibly because of the syntactic structure of the reverse scored items. In contrast, a modified TSK-13, comprised of only the positively scored items, revealed a 3-factor structure that is reliable and demonstrates adequate convergent, discriminant, and predictive validity.
Kinesiophobia is an important construct to evaluate in the transition from acute to chronic pain among children and adolescents. The 17 item Tampa Scale for Kinesiophobia (TSK) does not show adequate validity or reliability in youth undergoing major surgery, however, the psychometric properties of a 13-item modified scale (TSK-13) are promising.
本研究旨在评估 17 项坦帕运动恐惧量表（TSK）在青少年中的心理测量特性。
参与者为 264 名儿童和青少年（58.7%为女性，M=14.1 岁，SD=2.51），他们计划接受大手术，在手术前、住院期间和手术后 6 个月和 12 个月进行评估。进行探索性因素分析（EFA）以确定术前 TSK 评分的因素结构。检验了信度、聚合、区分和预测效度。
对 17 项 TSK 的 EFA 显示，正评分的 13 项与 4 项反向评分项区分出两个因素模型，但拟合效果不佳。对正评分的 13 项（TSK-13）进行了第二次 EFA，显示出三因素模型：对受伤的恐惧、身体脆弱性和活动回避。TSK-13 具有足够的内部一致性（Ω=0.82）和较弱的聚合效度。TSK-13 与术后住院期间的体力活动（活动记录仪；r（179）=-0.10，p=0.18）不相关，且与抑郁（r（225）=0.41，p<0.001）和一般焦虑（r（224）=0.35，p<0.001）的测量值具有足够的区分效度，即相关性小于 0.70。对 12 个月时与疼痛相关的残疾的预测效度（r（70）=0.34，p<0.001）是足够的。
原始 TSK-17 似乎不是手术后青少年运动恐惧的有意义的测量方法，可能是因为反向评分项的句法结构。相比之下，由正评分项组成的改良 TSK-13 显示出可靠的三因素结构，具有足够的聚合、区分和预测效度。
运动恐惧是评估儿童和青少年从急性疼痛向慢性疼痛过渡的一个重要结构。17 项坦帕运动恐惧量表（TSK）在接受大手术的青少年中表现出较差的有效性和可靠性，然而，一项 13 项改良量表（TSK-13）的心理测量特性具有很大的发展前景。
