Evaluation of a two-dimensional scale for the assessment of fear avoidance beliefs in elderly chronic low back pain patients

• Published in: Schmerz (Berlin, Germany) Germany), 2011-06, Vol.25 (3), p.315-321
• Main Authors: Quint, S, Raich, M, Luckmann, J
• Format: Article
• Language: ger
• Subjects: Activities of Daily Living - classification; Activities of Daily Living - psychology; Aged; Aged, 80 and over; Anxiety - diagnosis; Anxiety - psychology; Avoidance Learning; Catastrophization - diagnosis; Catastrophization - psychology; Cross-Sectional Studies; Culture; Fear; Female; Humans; Low Back Pain - psychology; Male; Middle Aged; Motor Activity; Pain Measurement - psychology; Psychometrics - statistics & numerical data; Quality of Life - psychology; Reproducibility of Results; Sick Role; Surveys and Questionnaires
• ISSN: 1432-2129
• DOI: 10.1007/s00482-011-1038-z

There is evidence on the importance of fear avoidance beliefs (FAB) as prognostic risk factors in elderly patients suffering from chronic low back pain (CLBP). However, so far there is no validated German instrument for measuring FAB in elderly CLBP patients. The aim of the study presented was to evaluate the psychometric properties of the Catastrophizing Avoidance Scale D-65+ (CAS-D-65+) within a population of elderly patients with CLBP. A cross-sectional study was conducted with measurement repeated after 4 weeks in 68 CLBP patients aged 64 years and older. The CAS-D-65+ was analyzed performing an item analysis and retest reliability. For validation standardized assessment methods (Tampa Scale of Kinesiophobia [TSK], Photography of Daily Activity - Short electronic Version [Phoda-SeV], 5-Item-FAB, pain, disability, well-being and strain) were used. Internal consistency (Cronbach's α) ranged from 0.87 to 0.92 for total scale and from 0.71 to 0.89 for the sub-scales "catastrophizing" and "avoidance", retest reliability (r(tt)) ranged from 0.67 for the sub-scale "catastrophizing" to 0.70 for total scale and sub-scale "avoidance". The CAS-D-65+ showed moderate and strong effect sizes (Cohen's d) with other related FAB scales and external criteria. As shown in this study the CAS-D-65+ is a reliable and a valid instrument for the assessment of FAB in older patients with CLBP.