Little is known about practitioners' beliefs and attitudes to the treatment of low back pain, and whether these influence their clinical decisions, intervention strategies, and patient-centered outcomes. This study aimed to develop, test, and explore the underlying dimensions of a new questionnaire, the Attitudes to Back Pain Scale (ABS), in a specific group of clinicians, practitioners who specialize in musculoskeletal therapy.
Items for the draft questionnaire were derived from interviews with practitioners (chiropractors, osteopaths, and physiotherapists). The draft questionnaire (52 items) sought to assess practitioners' attitudes concerning role and self-image plus their beliefs about treatment goals and prognosis of low back pain. The questionnaire was sent to a random selection of 300 practitioners from each professional group, and 546 (61%) responded. Split-sample analyses were performed using exploratory and confirmatory factor analysis.
Separate exploratory analyses were done for attitudes concerned with personal interaction (34 items) and attitudes about treatment orientation (18 items), producing six domains: limitations on sessions, psychologic, connection to health care system, confidence and concern, reactivation, and biomedical. Confirmatory analyses indicated that the model tested presented a good fit. Validity interviews revealed high agreement of categorization and low levels of difficulty in categorizing the items.
The internal structure of the new questionnaire not only shows excellent psychometric properties and good face validity, but also has the added advantage of being developed with a specific clinical context in mind. Additional evaluation is required to fully describe the psychometric integrity of this instrument.
*Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UK
†Research Centre, The British School of Osteopathy, London, UK
‡Institute for Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, Bournemouth, Dorset, UK
§Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire, UK
¶Institute of Community Health Sciences, Barts and The London, Queen Mary University of London, London, UK
This study was supported by a project grant from the Economic and Social Research Council.
Reprints: T. Pincus, Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK (e-mail: firstname.lastname@example.org).
Received for publication December 8, 2004; revised June 17, 2005; accepted June 25, 2005