Developing a Short Form of the German Barriers Questionnaire II: A Validation Study in Four Steps

Patient-related barriers to cancer pain management are most commonly assessed with the Barriers Questionnaire II (BQII; 27 items).

The aim of this study was to develop a valid short form of the BQII-German version (BQII-G) to increase usability in clinical routines and reduce patient burden.

The validation study comprised a stepwise approach. In the first step, the linguistic validated version of the BQII-G was psychometrically tested for internal consistency and factor structure (N = 207). The second step included an independent peer review in terms of expert ratings (four nurses and two patients) of each of the BQII-G items regarding (rather) include or (rather) not include, according to the content validity index. The third step comprised a consensus process to integrate the expert ratings into a short form of the BQII-G (BQII-G12). The fourth step included a preliminary psychometric exploration of the short version of BQII-G12.

Cronbach's α was 0.92 for the BQII-G. Steps 1-3 resulted in the BQII-G12 (12 items). The correlation showed that the BQII-G12 explains 84.3% (r = 0.92) of the variance of the BQII-G. Cronbach's alpha of the BQII-G12 was 0.833.

The BQII-G12 showed excellent psychometric properties in the preliminary testing, providing a new option for practice and research. Patient-related barriers to cancer pain management are crucial for adequate pain treatment. The new valid and reliable short BQII-G12 supports clinical practice and research by substantially reducing patient burden and resources needed to measure these barriers.