Cross-cultural adaptation, validity and reproducibility of the Back Beliefs Questionnaire among older Brazilians with acute low back pain. A cross-sectional study

Abstract

BACKGROUND: Low back pain (LBP) has emerging as an epidemic, multifactorial and multidimensional condition in older age. Assessment of attitudes and beliefs of patients with back pain is necessary for understanding the impact of psychosocial factors on pain perception and management. OBJECTIVES: To cross-culturally adapt and examine the validity and reproducibility (intra and interrater reliability and agreement) of the Back Beliefs Questionnaire (BBQ) in older Brazilians with acute LBP. DESIGN AND SETTING: Cross-sectional methodological report conducted at the Department of Physical Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. METHODS: The present study was conducted for translating, adapting, and examining the psychometric properties of a questionnaire. Participants aged ≥ 60 years experiencing an acute episode of LBP were recruited. Coefficients of internal consistency, reliability and agreement were obtained using Cronbach’s α, intraclass correlations, and standard error of measurement and the smallest detectable change, respectively. RESULTS: Twenty-six participants aged between 60-84 years and reporting a mean of 9.8 (4.3) years of schooling completed the study. The Brazilian Portuguese-language version of the BBQ (BBQ-Brazil) was proposed and presented with adequate conceptual, semantic, operational, and measurement equivalence from the original version. Intra and interrater evaluations showed moderate (0.74) and excellent (0.91) intraclass correlation coefficients, respectively, with small standard error of measurement for both evaluations. Internal consistency was considered adequate (0.70). CONCLUSION: BBQ-Brazil had consistent measurements of validity and reproducibility, and proved to be a valuable tool in clinical practice for addressing attitudes and beliefs of older patients with acute LBP.

The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain

“…Test-retest reliability of the Hausa-BBQ demonstrated a highly significant correlation (ICC = 0.91), suggesting acceptable reliability. Remarkably, our ICC was higher than the value (0.87) obtained for the original English version [20] and the range of 0.64-0.89 reported by several translated versions [31,32,[34][35][36][37][38]41,42] (Table 6). Additionally, the ICC values obtained for the urban and rural subgroups in the present study were also excellent and comparable to those obtained for the overall population.…”

“…Internal consistency calculated for the Hausa-BBQ (α = 0.78) was adequate considering the acceptable value of 0.70 [57]. Our alpha coefficient is slightly higher than the 0.70 reported for the original English measure [20], and the range of 0.67−0.77 reported by many language versions [31,32,34,36,37,42,43]. Other adaptations, however, reported slightly higher alpha coefficients (α range = 0.79-0.82) [33,35,38,39,40] (Table 6).…”

“…Cronbach's α coefficients were interpreted as "inadequate" (< 0.70), "adequate" (0.70-0.79), "good" (0.80-0.89), and "excellent" (> 0.90) [62]. We hypothesized that the Cronbach's α coefficients for the Hausa-BBQ would lie within the range of 0.70-0.82 to be considered acceptable [31,33,36,40,42].…”

“…This was done for both the global and 9-item scores. We hypothesized that the LOA 95% for the Hausa-BBQ would lie within the range of -10.0 to +12.6 [31,34,42]. Subgroup reliability analyses regarding ICC, SEM and MDC 95 for urban and rural patients were also performed.…”

“…Furthermore, it has been shown to predict recovery rate from LBP [29]. The original English BBQ proved to be valid and reliable [20,30], and has been adapted and validated for use in several languages/cultures [31][32][33][34][35][36][37][38][39][40][41].…”