Díaz-Fernández Ángeles, Ortega-Martínez Ana Raquel, Cortés-Pérez Irene, Ibáñez-Vera Alfonso Javier, Obrero-Gaitán Esteban, Lomas-Vega Rafael
Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain.
Department of Psychology, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain.
J Clin Med. 2023 Sep 19;12(18):6045. doi: 10.3390/jcm12186045.
Low back pain (LBP) is one of the main musculoskeletal pain conditions, and it affects 23-28% of the global population. Strong evidence supports the absence of a direct relationship between the intensity of pain and tissue damage, with psychosocial factors also playing a crucial role. In this context, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a useful tool for evaluating physiotherapists' treatment orientations and beliefs regarding the management of low back pain (LBP). It helps identify practitioners who may benefit from additional education in modern pain neuroscience. However, there is not a Spanish validation of this scale for physiotherapists. Thus, the aims of this study were to translate and culturally adapt the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) into Spanish and to evaluate its psychometric properties. This validation study used three convenience samples of physiotherapists (PTs) ( = 22 for the pilot study, = 529 for the validity study and = 53 for assessing the instrument's responsiveness). The process of translating and adapting the PABS-PT into Spanish followed international guidelines and produced a satisfactory pre-final version of the questionnaire. Factor analysis confirmed the two-factor structure of the original version, with the biomedical (BM) factor explaining 39.4% of the variance and the biopsychosocial (BPS) factor explaining 13.8% of the variance. Cronbach's alpha values were excellent for the BM factor (0.86) and good for the BPS factor (0.77), indicating good internal consistency. Test-retest reliability was excellent for both factors, with intraclass correlation coefficients (ICCs) of 0.84 for BM and 0.82 for BPS. The standard error of measurement (SEM) was acceptable for both factors (3.9 points for BM and 2.4 points for BPS). Concurrent validity was moderate and in the expected direction and had significant correlations with the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and Revised Neurophysiology Pain Questionnaire (R-NPQ). Sensitivity to change was demonstrated by significant improvements in both factors after an educational intervention, with medium-to-large effect sizes. The PABS-PT also showed good discriminative ability, as it was able to distinguish between physiotherapists with and without pain education. Cut-off values for the BM and BPS factors were determined. In conclusion, the translated and adapted Spanish version of the PABS-PT demonstrated good psychometric properties and can be reliably used to assess the attitudes and beliefs of Spanish-speaking physiotherapists regarding LBP. The questionnaire is recommended for use in clinical and educational research in the Spanish language context.
腰痛（LBP）是主要的肌肉骨骼疼痛病症之一，全球23%-28%的人口受其影响。有力证据表明疼痛强度与组织损伤之间不存在直接关系，社会心理因素也起着关键作用。在此背景下，物理治疗师疼痛态度与信念量表（PABS-PT）是评估物理治疗师对腰痛（LBP）管理的治疗取向和信念的有用工具。它有助于识别可能从现代疼痛神经科学的额外教育中受益的从业者。然而，该量表尚未在西班牙对物理治疗师进行验证。因此，本研究的目的是将物理治疗师疼痛态度与信念量表（PABS-PT）翻译成西班牙语并进行文化调适，并评估其心理测量特性。这项验证研究使用了三个物理治疗师（PT）的便利样本（试点研究n = 22，效度研究n = 529，评估工具反应性n = 53）。将PABS-PT翻译成西班牙语并进行调适的过程遵循国际指南，产生了一份令人满意的预终版问卷。因子分析证实了原始版本的两因素结构，生物医学（BM）因子解释了39.4%的方差，生物心理社会（BPS）因子解释了13.8%的方差。BM因子的克朗巴哈α值极佳（0.86），BPS因子的克朗巴哈α值良好（0.77），表明内部一致性良好。重测信度对两个因子均极佳，BM因子的组内相关系数（ICC）为0.84，BPS因子的组内相关系数为0.82。两个因子的测量标准误（SEM）均可接受（BM为3.9分，BPS为2.4分）。同时效度中等且符合预期方向，与医疗保健提供者疼痛与损伤关系量表（HC-PAIRS）和修订的神经生理学疼痛问卷（R-NPQ）有显著相关性。教育干预后两个因子均有显著改善，效应量为中到大，表明对变化敏感。PABS-PT还显示出良好的区分能力，因为它能够区分接受过疼痛教育和未接受过疼痛教育的物理治疗师。确定了BM和BPS因子的临界值。总之，翻译并调适后的西班牙语版PABS-PT显示出良好的心理测量特性，可可靠地用于评估讲西班牙语的物理治疗师对LBP的态度和信念。建议在西班牙语环境的临床和教育研究中使用该问卷。
