Cross-Cultural Adaptation and Validation of the Back Beliefs Questionnaire to the Arabic Language

Study Design.Translation, cross-cultural adaptation, and psychometric testing.Objective.To translate the Back Beliefs Questionnaire (BBQ) into Arabic and investigate its psychometric properties in an Arabic-speaking sample of individuals with low back pain (LBP).Summary of Background Data.Back pain beliefs are associated with pain chronicity and disability in people with LBP. The BBQ is a recognized and frequently used tool for measuring these beliefs. To date the BBQ has not been translated into Arabic.Methods.The English version of the BBQ was translated and culturally adapted into Arabic (BBQ-Ar) according to published guidelines. The BBQ-Ar was then tested in a sample of 115 Arabic-speaking individuals with LBP. Reliability was evaluated through internal consistency (Cronbach ) and test-retest reliability (intraclass correlation coefficient), the latter in a subgroup of 25. Construct validity was assessed using exploratory factor analysis and by examining the correlation between the BBQ-Ar, the Oswestry Disability Index and a Numerical Pain Rating Scale.Results.Internal consistency of the BBQ-Ar was good (Cronbach =0.77). Test-retest reliability was good (intraclass correlation coefficient [2,1]=0.88). Exploratory factor analysis revealed a three-factor structure, explaining 46% of total variance, with the first factor alone explaining 24%. Eight of the nine scoring items were loaded on the first factor thus forming a unidimensional scale. A significant negative correlation was found between Oswestry Disability Index and BBQ-Ar scores (r=-0.307; P<0.01), whereas no significant correlation was found between BBQ-Ar and Pain Rating Scale scores. No floor or celling effects were observed.Conclusion.The BBQ-Ar is a valid and reliable tool that can be used to assess back pain beliefs in Arabic-speaking individuals.Level of Evidence: N/A