The Chinese version of the Back Pain Attitudes Questionnaire: Translation, cross-cultural adaptation and validation
Shuzhen Lu1, Ben Darlow2, Qunyan Xiang3
1Hunan Normal University, Changsha, Hunan, China; Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China.
Background:
Low back pain (LBP) is a highly prevalent and disabling condition globally. Assessing unhelpful beliefs is crucial for effective management. The Back-PAQ is a widely used instrument for evaluating attitudes and beliefs about LBP, but a Chinese version has not yet been developed and validated.
Objectives:
To translate and cross-culturally adapt the Back-PAQ into Chinese (Back-PAQ-CH) and to test its measurement properties in individuals with LBP.
Methods:
The Back-PAQ was translated and cross-culturally adapted following established guidelines using a forward-backward translation method. A total of 472 individuals with LBP were recruited to complete the questionnaire. The collected data were used to assess the scale's validity and reliability.
Results:
The Back-PAQ was successfully translated and adapted into Chinese. Content validity was high, as evidenced by I-CVI values of 0.860-1.000 and an S-CVI/UA of 0.850. Confirmatory factor analysis supported a robust five-factor structure, with model fit indices indicating good overall fit (χ2/df = 1.40, RMSEA = 0.038, RMR = 0.046, TLI = 0.955, CFI = 0.959, IFI = 0.959). Internal consistency was excellent (Cronbach's α = 0.915), and test-retest reliability was high (ICC = 0.973) with a small measurement error (SEM = 2.16, MDC90 = 5.04). Item-total correlations (0.375-0.652) and critical ratios (3.964-9.436) confirmed good item discrimination.
Conclusion:
The Chinese version of the Back-PAQ demonstrates good reliability and validity, and could be used as an effective tool to evaluate the attitudes and beliefs of Chinese populations with LBP.
