Cross-cultural adaptation and validity of the Spanish fear-avoidance components scale and clinical implications in primary care

Cuesta-Vargas, Antonio I.Neblett, RandyGatchel, Robert J.Roldán-Jiménez, Cristina2022-09-122022-09-122020-02-27Cuesta-Vargas AI, Neblett R, Gatchel RJ, Roldán-Jiménez C. Cross-cultural adaptation and validity of the Spanish fear-avoidance components scale and clinical implications in primary care. BMC Fam Pract. 2020 Feb 27;21(1):44http://hdl.handle.net/10668/4029Background: Pain-related fear-avoidance (FA) is a common problem affecting many patients with painful medical conditions. As there is great interest in the clinical importance of the relationship between FA and disability, severalquestionnaires have been developed to measure FA. The Fear-Avoidance Components Scale (FACS) is a recently developed patient-reported instrument that addresses critical issues not previously considered in previous FA related questionnaires. The original English version of the FACS demonstrated good reliability, internal consistency, and construct, criterion, and predictive validity. Two factors were determined: General Fear Avoidance and Types of Activities That are Avoided. The aim of this study was to to translate the FACS into European-style Spanish (FACSSp), and validate its psychometric properties. Methods: This two-stage psychometric study included 330 subjects with various chronic musculoskeletal paindisorders. An initial translation and cross-cultural adaptation of the FACS, from English to Spanish, was performed.Then, critical psychometric properties were analysed, including internal consistency by Cronbach’s α coefficients, structural validity from the Maximum Likelihood Extraction (MLE), and convergent validity by Pearson correlation with the Central Sensitization Inventory (CSI). Results: This study reports for the first time the psychometric properties of the Spanish version of the FACS. Total scores ranged from 0 to 88 points, with a mean of 30.49 (±17.18). The FACS-Sp showed a high internal consistency for factor 1 (α = 0.902) and factor 2 (α = 0.88). Factor structure was two-dimensional and supported structural validity, accounting for 48.75% of the total variance. Convergent validity analysis found a significant Pearson correlation r = 0.414. Conclusion: This study reports for the first time the psychometric properties of the Spanish version of the FACS-Sp. Psychometric properties supported the validation of FACS-Sp and ensured the conceptual equivalence with the original English version. In primary care and chronic pain rehabilitation, FA assessment is crucial for clinical decisionmaking and treatment guidance. The FACS-Sp offers a new measure of FA in Spanish speaking populations. Future research on the FACS-Sp should evaluate test-retest reliability, treatment responsiveness and psychometric comparisons with other translated versions.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Fear-avoidanceThe fear-avoidance components scaleFACSChronic musculoskeletal pain disordersPatient health questionnaireDecision makingPrimary careCitometría de flujoDolor musculoesqueléticoCuestionario de salud del pacienteToma de decisionesAtención primaria de saludAndalucíaMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Chronic DiseaseMedical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Anthropology::Anthropology, Cultural::Culture::Cross-Cultural ComparisonMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional StudiesMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Emotions::FearMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Information Science::Information Science::Data Collection::QuestionnairesMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health CareMedical Subject Headings::Psychiatry and Psychology::Behavioral Disciplines and Activities::Psychological Tests::PsychometricsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Reproducibility of ResultsMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Information Science::Information Science::Communications Media::Publications::TranslationsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Weights and MeasuresMedical Subject Headings::Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Learning::Avoidance LearningMedical Subject Headings::Diseases::Musculoskeletal Diseases::Muscular Diseases::Musculoskeletal PainCross-cultural adaptation and validity of the Spanish fear-avoidance components scale and clinical implications in primary careresearch article32106823Acceso abierto10.1186/s12875-020-01116-x1471-2296PMC7047382