Arabic version of the Back Pain Attitudes Questionnaire: Translation, cross-cultural adaptation, and psychometric properties

BACKGROUND The Back Pain Attitudes Questionnaire (Back-PAQ) is a tool developed for the assessment of attitudes about back pain. However, this tool is not available in the Arabic language. The availability of the Arabic version of the questionnaire will enable clinicians and researchers in Arabic-speaking countries to assess patients' attitudes towards back pain. OBJECTIVE We aimed to translate and cross-culturally adapt the English version of the Back-PAQ into Arabic and study its psychometric properties. METHODS The translation and cross-cultural adaptation processes were performed according to published guidelines. The translated Arabic version was tested for face and content validity on 40 participants. The psychometric properties of the final Arabic version were tested on 110 participants. Participants completed the Arabic version of the Back-PAQ and Fear-Avoidance Beliefs Questionnaire (FABQ). A subgroup of 50 participants completed the questionnaire twice in a week interval to determine the Back-PAQ test-retest reliability. RESULTS The majority of participants found the questionnaire understandable and the questions relevant and appropriate for their back problem. There was a fair correlation between the Back-PAQ-Arabic and the FABQ physical activity scale (rho = 0.283, p= 0.001), and little to no correlation with total FABQ (rho = 0.186, p= 0.026) and education level (rho =-0.162, p= 0.045). The Arabic Back-PAQ-Arabic showed moderate internal consistency with Cronbach's α of 0.601, and excellent test-retest reliability (ICC2,1= 0.963). The Back-PAQ standard error of measurement was 3.57 and minimum detectable changes was 9.90. CONCLUSION The Arabic version of the Back-PAQ has adequate validity and reliability properties.