Psychometric Testing Confirms That the Brazilian-Portuguese Adaptations, the Original Versions of the Fear-Avoidance Beliefs Questionnaire, and the Tampa Scale of Kinesiophobia Have Similar Measurement Properties

Abstract

Translation, cross-cultural adaptation, and psychometric testing of 2 questionnaires. The objectives of this study were to translate and cross-culturally adapt the Fear-Avoidance Beliefs Questionnaire (FABQ) to Brazilian-Portuguese and to test the psychometric properties of the Brazilian-Portuguese versions of the FABQ and the Tampa Scale of Kinesiophobia (TSK). Self-report measures of fear-avoidance have been widely used in clinical practice and in research. To date there is no Brazilian-Portuguese version of the FABQ and the Brazilian-Portuguese TSK has not yet been comprehensively tested. The FABQ was cross-culturally adapted after the recommendations from the Guidelines for the process of cross-cultural adaptation of self-report measures. The Brazilian-Portuguese versions of the FABQ and the TSK were tested for internal consistency, reproducibility, ceiling and floor effects, construct validity, and internal and external responsiveness. Both instruments yielded high values for internal consistency and reproducibility [(Cronbach's alpha FABQ = 0.93 and TSK = 0.82) and (Intraclass Correlation Coefficient FABQ = 0.96 and TSK = 0.93)]. No ceiling and floor effects were detected in either questionnaire. The FABQ and TSK were highly correlated (r = 0.86) and they were moderately correlated with the pain numerical rating scale at baseline (r = 0.42 and r = 0.43, respectively) showing good construct validity. The TSK was shown to be more responsive than the FABQ in all internal and external responsiveness analyses. Both the Brazilian-Portuguese versions of the FABQ and the TSK are equally useful in terms of description and identification of patients with fear-avoidance behavior; however, in situations that clinicians or researchers aimed to use fear-avoidance as a follow-up measurement for treatment outcomes it seems that the TSK is the better option due to its better capacity to identify change over time.