Naye Florian, Décary Simon, Tousignant-Laflamme Yannick
School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Qc, J1H 5N4, Canada.
Clinical Research of the Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Qc, J1H5N4, Canada.
Arch Physiother. 2022 May 16;12(1):14. doi: 10.1186/s40945-022-00137-2.
Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish this biopsychosocial profile. Yet, there is no tool to facilitate its integration into clinical practice. Thus, the aim of this study is to develop a rating scale and validate its content, to rapidly establish the patient's biopsychosocial profile, based on the five domains of the PDDM.
The tool was developed in accordance with the principles of the COSMIN methodology. We conducted three steps: 1) item generation from a comprehensive review, 2) refinement of the scale with clinicians' feedback, and 3) statistical analyses to assess content validity. To validate the item assessing with Likert scales, we performed Item level-Content Validity Index (I-CVI) analyses on three criteria (clarity, presentation and clinical applicability) with an a priori threshold of > 0.78. We conducted Average-Content Validity Index (Ave-CVI) analyses to validate the overall scale with a threshold of > 0.9.
In accordance with the PDDM, we developed a 5-item rating scale (1 per domain) with 4 score options. We selected clinical instruments to screen for the presence or absence of problematic issues within each category of the 5 domains. Forty-two participants provided feedback to refine the scale's clarity, presentation, and clinical applicability. The statistical analysis of the latest version presented I-CVI above the threshold for each item (I-CVI ranged between 0.94 and 1). Analysis of the overall scale supported its validation (Ave-CVI = 0.96 [0.93;0.98]).
From the 51 biopsychosocial elements contained within the 5 domains of the PDDM, we developed a rating scale that allows to rapidly screen for problematic issues within each category of the PDDM's 5 domains. Involving clinicians in the process allowed us to validate the content of the first scale to establish the patient's biopsychosocial profile for people with low back pain. Future steps will be necessary to continue the psychometric properties analysis of this rating scale.
建立腰痛（LBP）患者的生物心理社会档案对于个性化护理至关重要。疼痛与残疾驱动因素管理模型（PDDM）被认为是帮助临床医生建立这种生物心理社会档案的有用框架。然而，目前尚无工具来促进其融入临床实践。因此，本研究的目的是开发一种评分量表并验证其内容，以便基于PDDM的五个领域快速建立患者的生物心理社会档案。
该工具是根据COSMIN方法学的原则开发的。我们进行了三个步骤：1）通过全面综述生成条目；2）根据临床医生的反馈完善量表；3）进行统计分析以评估内容效度。为了验证用李克特量表评估的条目，我们在三个标准（清晰度、呈现方式和临床适用性）上进行了条目水平的内容效度指数（I-CVI）分析，先验阈值设定为>0.78。我们进行了平均内容效度指数（Ave-CVI）分析以验证整个量表，阈值设定为>0.9。
根据PDDM，我们开发了一个包含5个条目的评分量表（每个领域1个），有4个评分选项。我们选择了临床工具来筛查5个领域中每个类别内是否存在问题。42名参与者提供了反馈，以完善量表的清晰度、呈现方式和临床适用性。对最新版本的统计分析显示，每个条目的I-CVI均高于阈值（I-CVI范围在0.94至1之间）。对整个量表的分析支持了其有效性验证（Ave-CVI = 0.96 [0.93;0.98]）。
从PDDM的5个领域中包含的51个生物心理社会要素出发，我们开发了一种评分量表，该量表能够快速筛查PDDM的5个领域中每个类别内的问题。让临床医生参与这一过程使我们能够验证首个量表的内容，从而为腰痛患者建立其生物心理社会档案。未来还需要进一步对该评分量表的心理测量特性进行分析。
