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Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity

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Abstract

Background

Growing attention is being given to cognitive-behavioural measures to improve interventions for spinal disorders. The Pain Vigilance and Awareness Questionnaire (PVAQ) has never been validated in Italian subjects with chronic low back pain (LBP).

Purpose

The purpose of this study is translating, culturally adapting and validating the Italian version of PVAQ (PVAQ-I).

Methods

A cross-sectional evaluation of the psychometric properties of the PVAQ-I on patients with chronic LBP was conducted. The questionnaire was culturally adapted in accordance with international standards. The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intra-class correlation coefficient, ICC); construct validity by comparing the PVAQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS), the Chronic Pain Acceptance Questionnaire (CPAQ), a Numerical Rating Scale of pain intensity (NRS) and the Oswestry Disability Questionnaire (ODI); and sensitivity to change by calculating the smallest detectable change.

Results

The PVAQ-I was administered to 131 subjects with chronic LBP (77 females, mean age of 48 ± 16 years, median symptoms duration of 12 months). Factor analysis confirmed a two-factor (passive awareness and active vigilance), 13-item solution, which led to an acceptable data-model fit. Internal consistency (α = 0.91) and test–retest reliability (ICC = 0.92) were good. As a priori hypothesized, construct validity showed moderate correlations between the PVAQ-I and PCS (r = 0.60), TSK (r = 0.44) and HADS-Anxiety (r = 0.53) and low correlations with HADS-Depression (r = 0.28), NRS (r = 0.28), ODI (r = 0.23) and CPAQ (r = −0.12). The smallest detectable change was 9.

Conclusion

The PVAQ was successfully translated into Italian and proved to have satisfactory psychometric properties. Its use is recommended for clinical and research purposes.

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Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Salvatore Maugeri Foundation, Institute of Care and Research, IRCCS, Scientific Institute of Lissone (Monza Brianza), Physical Medicine and Rehabilitation Unit, Via Monsignor Bernasconi 16, 20851, Lissone, Monza Brianza, Italy

    Marco Monticone, Emilia Ambrosini & Barbara Rocca

  2. Department of Electronics, Information and Bioengineering, Neuroengineering and Medical Robotics Laboratory, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano, 20133, Italy

    Emilia Ambrosini

  3. School of Physiotherapy, University of Milan, Milan, Italy

    Tiziana Nava

  4. School of Physical Medicine and Rehabilitation Unit, Bicocca University of Milan, Milan, Italy

    Erica Terragni & Cesare Cerri

  5. Psychology Department, Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, England

    Lance M McCracken

Authors
  1. Marco Monticone
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  2. Emilia Ambrosini
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  3. Barbara Rocca
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  4. Tiziana Nava
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  5. Erica Terragni
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  6. Cesare Cerri
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  7. Lance M McCracken
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Corresponding author

Correspondence to Marco Monticone.

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Monticone, M., Ambrosini, E., Rocca, B. et al. Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity. Int.J. Behav. Med. 23, 214–223 (2016). https://doi.org/10.1007/s12529-015-9507-x

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  • DOI: https://doi.org/10.1007/s12529-015-9507-x

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