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Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care

Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care
Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care
Choosing the most appropriate treatment for individual patients with low back pain (LBP) can be challenging, and clinical guidelines recommend taking into account patients’ preferences. However, no tools exist to assess or compare patients’ views about LBP treatments. We report the development and validation of the LBP Treatment Beliefs Questionnaire (LBP-TBQ) for use across different treatments in clinical practice and research. Using qualitative data we developed a pool of items assessing perceived credibility, effectiveness, concerns about and individual ‘fit’ of specific treatments. These items were included in a survey completed by 429 primary care patients with LBP, of whom 115 completed it again 1 to 2 weeks later. We performed psychometric analyses using non-parametric item response theory and classical test theory. The four subscales of the resulting 16-item LBP-TBQ showed good homogeneity (H=.46-.76), internal consistency (? =.73-.94), and stability (r=.63-.83), confirmed most convergent and discriminant validity hypotheses, and had acceptable structural validity for four guideline-recommended treatments: pain medication, exercise, manual therapy and acupuncture. Participants with stronger positive treatment beliefs were more likely to rank that treatment as their first choice, indicating good criterion validity (t values=3.11-9.80, all p<.01, except pain medication effectiveness beliefs, t(339)=1.35; p=.18). A short 4-item version also displayed good homogeneity (H=.43-.66), internal consistency (?=.70-.86), and stability (r=.82-.85), and was significantly related to treatment choice (t values=4.33-9.25, all p<.01). The LBP-TBQ can be used to assess treatment beliefs in primary care patients with LBP and to investigate the effects of treatment beliefs on treatment uptake and adherence.

low back pain, questionnaire validation, scale, psychometrics, treatment beliefs, medication beliefs, pain medication, exercise, manual therapy, acupuncture, non-parametric item response theory
0304-3959
1489-1500
Dima, Alexandra
91e9a8ef-49bd-4891-8e3c-61640a2666f5
Lewith, George T.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Foster, Nadine E.
2ca79c15-6ada-4b99-982c-f8abee19e628
Hankins, M.
ce4b7d68-3320-4af4-9dd7-3537a4b07219
Surtees, George
992be9b1-678f-4174-9b86-d90dc7976328
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Dima, Alexandra
91e9a8ef-49bd-4891-8e3c-61640a2666f5
Lewith, George T.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Foster, Nadine E.
2ca79c15-6ada-4b99-982c-f8abee19e628
Hankins, M.
ce4b7d68-3320-4af4-9dd7-3537a4b07219
Surtees, George
992be9b1-678f-4174-9b86-d90dc7976328
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928

Dima, Alexandra, Lewith, George T., Little, Paul, Moss-Morris, Rona, Foster, Nadine E., Hankins, M., Surtees, George and Bishop, Felicity L. (2015) Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care. Pain, 156 (8), 1489-1500. (doi:10.1097/j.pain.0000000000000193).

Record type: Article

Abstract

Choosing the most appropriate treatment for individual patients with low back pain (LBP) can be challenging, and clinical guidelines recommend taking into account patients’ preferences. However, no tools exist to assess or compare patients’ views about LBP treatments. We report the development and validation of the LBP Treatment Beliefs Questionnaire (LBP-TBQ) for use across different treatments in clinical practice and research. Using qualitative data we developed a pool of items assessing perceived credibility, effectiveness, concerns about and individual ‘fit’ of specific treatments. These items were included in a survey completed by 429 primary care patients with LBP, of whom 115 completed it again 1 to 2 weeks later. We performed psychometric analyses using non-parametric item response theory and classical test theory. The four subscales of the resulting 16-item LBP-TBQ showed good homogeneity (H=.46-.76), internal consistency (? =.73-.94), and stability (r=.63-.83), confirmed most convergent and discriminant validity hypotheses, and had acceptable structural validity for four guideline-recommended treatments: pain medication, exercise, manual therapy and acupuncture. Participants with stronger positive treatment beliefs were more likely to rank that treatment as their first choice, indicating good criterion validity (t values=3.11-9.80, all p<.01, except pain medication effectiveness beliefs, t(339)=1.35; p=.18). A short 4-item version also displayed good homogeneity (H=.43-.66), internal consistency (?=.70-.86), and stability (r=.82-.85), and was significantly related to treatment choice (t values=4.33-9.25, all p<.01). The LBP-TBQ can be used to assess treatment beliefs in primary care patients with LBP and to investigate the effects of treatment beliefs on treatment uptake and adherence.

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More information

Accepted/In Press date: 8 April 2015
e-pub ahead of print date: August 2015
Published date: August 2015
Keywords: low back pain, questionnaire validation, scale, psychometrics, treatment beliefs, medication beliefs, pain medication, exercise, manual therapy, acupuncture, non-parametric item response theory
Organisations: Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 375898
URI: http://eprints.soton.ac.uk/id/eprint/375898
ISSN: 0304-3959
PURE UUID: ac10a945-dc80-43d1-b1aa-5dca1fc8e951
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662

Catalogue record

Date deposited: 20 Apr 2015 12:02
Last modified: 12 Jul 2024 01:41

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Contributors

Author: Alexandra Dima
Author: George T. Lewith
Author: Paul Little ORCID iD
Author: Rona Moss-Morris
Author: Nadine E. Foster
Author: M. Hankins
Author: George Surtees

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