Cross-cultural Adaptation, Reliability and Validity of the Chinese Version of the Fear Avoidance Beliefs Questionnaire

The Fear Avoidance Beliefs Questionnaire (FABQ) was translated and cross-culturally adapted for China. Its psychometric properties were then evaluated in Chinese-speaking patients with low-back pain and the scales were tested for internal consistency, reproducibility, ceiling-and-floor effects, construct validity and responsiveness. A total of 15 patients were selected for pre-testing and a further 230 patients completed the FABQ (and other scales) at baseline and 14 days later. A test-retest reliability analysis was carried out on 61 of the 230 patients. The FABQ was found to be easily understood. Explorative factor analysis by principal components analysis, yielded a two-factor model for the FABQ relating to work and physical activity, and this was confirmed by confirmatory factor analysis using structural equation modelling. The FABQ yielded high values for internal consistency and reproducibility; no ceiling-and-floor effects were detected. Generally, the FABQ scales and baseline variables were weakly correlated. Cohen's effect size was 0.22 and responsiveness was low. It was concluded that the translation and adaptation of the FABQ into Chinese was successful; the scales had acceptable factor structure, internal consistency, test-retest reliability and construct validity.