Background & Aims
Biopsychosocial management aims to address physical, psychological, and social factors of musculoskeletal pain patients and is currently accepted as the most appropriate therapeutic approach for treatment adherence and a better prognosis. Specific questionnaires evaluate biopsychosocial factors, but most of these questionnaires are unidimensional, lengthy in their applicability and impractical for routine clinical use. Screening questions with acceptable validity and reliability would facilitate the systematic detection of these factors in the clinical settings. The healthcare paradigm has shifted towards value-based care. The participatory design involving stakeholders from the clinical setting is crucial in the development of assessment tools. This study aimed to develop and evaluate the content and face validity, and test-retest reliability of the biopsychosocial screening self-report questionnaire (Biopsychosocial Questionnaires; “BPS-Q”), in adults with musculoskeletal pain.
Methods
A three-step approach was followed. Stage 1: Involved identifying the user (physiotherapist) problem: “physiotherapist who treats patients with musculoskeletal pain needs to incorporate a biopsychosocial evaluation of their patients, which must be rapid, not overload the care system, enhancing treatment outcomes”. Using the design thinking methodology and reviewing the current literature and existing tools, we developed and assessed the content validity of the BPS-Q with input from end-users and key stakeholders. Stage 2: Face validity was tested with six health care experts (conducting a semi-structured interview using a case study with one of them), and with eight people with experiences acute, sub-acute and chronic musculoskeletal pain). We followed the Consensus based Standards for the selection of health Measurement Instruments (COSMIN) recommendations for assessing face validity. Stage 3: test-retest reliability (48 hours) in 49 participants with a shoulder pain.
Results
The BPS-Q includes eight domains for an efficient self-reported biopsychosocial screening tool: sleep quality, depression, anxiety, catastrophizing, self-efficacy, kinesiophobia, hypervigilance, family and friends social support. Each domain contains one item, except for depression (2 items), which are measured using an eleven-point Likert scale. It also includes two open text questions on traumatic events and treatment goals. Stage 2: Minor modifications were made to 6 out of 9 Likert questions, 3 out of 3 open-ended questions, and to the radial chart. This is despite obtaining an agreement percentage above 80% for the BPS-Q instrument. The interviewed expert recommended including in the ‘self-efficacy’ domain, removing one of the depression questions, and suggested changes to 6 Likert questions, which were implemented. Stage 3: all domains of BPS-Q obtained a `excellent reliability` (ICC between 0.76 and 0.93) (p-value <0.05).
Conclusions
The self-reported biopsychosocial screening questionnaire – BPS-Q – demonstrated adequate content and appearance validity, showing good test-retest reliability in a diverse sample of individuals with musculoskeletal disorders in the scapular and shoulder region. This study supports the BPS-Q questionnaire as an effective screening tool for identifying biopsychosocial factors in individuals with musculoskeletal pain. Its particular value lies in its availability in Spanish, filling a gap as several biopsychosocial tools are not accessible in that language.
Future research should assess its clinimetric properties as a screening tool for other musculoskeletal conditions. Upon confirming the instrument’s robustness, consideration should be given to translating and culturally adapting it into English, broadening its accessibility to clinicians worldwide.
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Presenting Author
Maria Jesus Mena-Iturriaga
Poster Authors
Maria Jesus Mena
PT, MSc
Universidad del Desarrollo; Texas Tech University Health Sciences Center
Lead Author
Francisco Mancilla-Lobos
Universidad del Desarrollo
Lead Author
Serghio Torreblanca-Vargas
Universidad del Desarrollo - Hospital Provincia Cordillera
Lead Author
Loreto Durcudoy-Perez
Universidad del Desarrollo
Lead Author
Isabel Grez-Crovari
Universidad del Desarrollo
Lead Author
Barbara Munizaga-Rodriguez
Universidad del Desarrollo
Lead Author
Angela Lombardi-Robertson
Universidad del Desarrollo
Lead Author
Jaime Leppe
Universidad del Desarrollo
Lead Author
Manuela Besomi
Universidad del Desarrollo; The University of Queensland
Lead Author
Paulina Araya-Castro
Universidad del Desarrollo
Lead Author
Topics
- Assessment and Diagnosis