Assessing Psycho-social Barriers to Rehabilitation in Injured Workers with Chronic Musculoskeletal Pain: Development and Item Properties of the Yellow Flag Questionnaire (YFQ)

Salathé, Cornelia Rolli; Trippolini, Maurizio; Terribilini, Livio Claudio; Oliveri, Michael

doi:10.1007/s10926-017-9728-8

Cited by 4 publications

(7 citation statements)

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“…With regard to sick leave or RTW issues, different study approaches are needed, addressing disabling work characteristics or maladaptive beliefs, emotions and fears. For example, a recent study presented the Yellow Flag Questionnaire (YFQ), 70 a mixture of established yellow flag questions developed via a Delphi process. 70 Moreover, a recent systematic review underlined the effectiveness of psychologically informed physical therapy (PIPT) for patients with persistent LBP with regard to the outcomes pain, pain interference, disability, and pain self-efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a recent study presented the Yellow Flag Questionnaire (YFQ), 70 a mixture of established yellow flag questions developed via a Delphi process. 70 Moreover, a recent systematic review underlined the effectiveness of psychologically informed physical therapy (PIPT) for patients with persistent LBP with regard to the outcomes pain, pain interference, disability, and pain self-efficacy. Further high-quality investigations, however, are needed to gain knowledge about the cost-effectiveness of PIPT.…”

Section: Discussionmentioning

confidence: 99%

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Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review

Salathé

Melloh

Crawford

et al. 2018

Global Spine Journal

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Study Design: Systematic review. Objectives: To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of life, and work ability/sick leave. Methods:We carried out a systematic search of Web of Science, Cochrane Library, PubMed Central, EMBASE, and PsycINFO for English-and German-language literature published between January 2010 and July 2017. Study selection consisted of exclusion and inclusion phases. After screening for duplication, studies were excluded on the basis of criteria covering study design, number of participants, language of publication, and provision of information about the intervention. All the remaining articles dealing with the efficacy, utility, or cost-effectiveness of intensive (more than 25 hours per week) MBR encompassing at least 3 health domains and cognitive behavioral therapy-based psychological education were included. Results:The search retrieved 1199 publications of which 1116 were duplicates or met the exclusion criteria. Seventy of the remaining 83 articles did not meet the inclusion criteria; thus 13 studies were reviewed. All studies reporting changes in pain intensity or disability over 12 months after MBR reported moderate effect sizes and/or p-values for both outcomes. The effects on health-related quality of life were mixed, but MBR substantially reduced costs. Overall MBR produced an enduring improvement in work ability despite controversy and variable results.Conclusions: MBR is an effective treatment for nonspecific LBP, but there is room for improvement in cost-effectiveness and impact on sick leave, where the evidence was less compelling.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review

Salathé

Melloh

Crawford

et al. 2018

Global Spine Journal

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“…The total score ranges from 0-100, and high scores indicate that individuals’ multi-factor psychosocial states are affected due to chronic pain. The original version of the YFQ was found to have high reliability (Cronbach alpha = 0.91) and discriminant validity [ 4 ].…”

Section: Methodsmentioning

confidence: 99%

“…The Yellow Flag Questionnaire (YFQ) is a recently developed, multidimensional assessment tool used for assessment of pain-related psychosocial risk factors among individuals with chronic musculoskeletal pain (CMP) [ 4 ]. The tool provides a comprehensive assessment of psychosocial risk factors related to chronic pain in 32 items and 7 subgroups (activity, work, emotions, harm & blame, diagnosis beliefs, co-morbidity, and control).…”

Section: Introductionmentioning

confidence: 99%

Cross-cultural adaptation and validation of the Turkish Yellow Flag Questionnaire in patients with chronic musculoskeletal pain

et al. 2021

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Background Yellow flags are psychosocial factors shown to be indicative of long-term chronicity and disability. The purpose of the study was to evaluate the psychometric properties of the Turkish Yellow Flag Questionnaire (YFQ) in patients with chronic musculoskeletal pain (CMP). Methods The cross-cultural adaptation was conducted with translation and back-translation of the original version. Reliability (internal consistency and test-retest) was examined for 231 patients with CMP. Construct validity was assessed by correlating the YFQ with the Hospital Anxiety and Depression Scale (HADS), Orebro Musculoskeletal Pain Questionnaire (OMPQ), and Tampa Kinesiophobia Scale (TKS). Factorial validity was examined with both exploratory and confirmatory factorial analysis. Results The YFQ showed excellent test/retest reliability with an Intraclass correlation coefficient of 0.82. The internal consistency was moderate (Cronbach’s alpha of 0.797). As a result of the exploratory factor analysis, there were 7 domains compatible with the original version. As a result of confirmatory factor analysis, the seven-factor structure of YFQ was confirmed. There was a statistically significant correlation between YFQ-total score and OMPQ (r = 0.57, P < 0.001), HADS-anxiety (r = 0.32, P < 0.001), HADS-depression (r = 0.44, P < 0.001), and TKS (r = 0.37, P < 0.001). Conclusions This study’s results provide considerable evidence that the Turkish version of the YFQ has appropriate psychometric properties, including test-retest reliability, internal consistency, construct validity and factorial validity. It can be used for evaluating psychosocial impact in patients with CMP.

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“…Although the prognosis of unspecific low back pain is good, for some patients the pain becomes persistent, reducing their health-related quality of life (HRQoL), including their physical, mental, emotional and social functioning [2,3]. For persistent, chronic low back pain (CLBP), comprehensive treatment integrating biopsychosocial features is recommended [4][5][6]. Therefore, not only disease-specific but also the comprehensive measurement of pain and pain-related psychosocial co-factors is needed.…”

Section: Introductionmentioning

confidence: 99%

Comprehensiveness and validity of a multidimensional assessment in patients with chronic low back pain: a prospective cohort study

Benz

Lehmann

Sándor

et al. 2021

BMC Musculoskelet Disord

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Background Chronic low back pain is a multidimensional syndrome affecting physical activity and function, health-related quality of life and employment status. The aim of the study was to quantify the cross-sectional and longitudinal validity of single measurement scales in specific construct domains and to examine how they combine to build a comprehensive outcome, covering the complex construct of chronic low back pain before and after a standardized interdisciplinary pain program. Methods This prospective cohort study assessed 177 patients using the Short Form 36 (SF-36), the Multidimensional Pain Inventory (MPI), the Symptom Checklist-90-Revised (SCL-90-R), the Oswestry Disability Index (ODI), and 2 functional performance tests, the Back Performance Scale (BPS) and the 6-Minute Walking Distance (6MWD). The comprehensiveness and overlap of the constructs used were quantified cross-sectionally and longitudinally by bivariate correlations, exploratory factor analysis, and effect sizes. Results The mean age of the participants was 48.0 years (+/− 12.7); 59.3% were female. Correlations of baseline scores ranged from r = − 0.01 (BPS with MPI Life control) to r = 0.76 (SF-36 Mental health with MPI Negative mood). SF-36 Physical functioning correlated highest with the functional performance tests (r = 0.58 BPS, 0.67 6MWD) and ODI (0.56). Correlations of change scores (difference of follow-up – baseline score) were consistent but weaker. Factor analysis revealed 2 factors: “psychosocial” and “pain & function” (totally explained variance 44.0–60.9%). Psychosocial factors loaded strongest (up to 0.89 SCL-90-R) on the first factor, covering 2/3 of the explained variance. Pain and function (ing) loaded more strongly on the second factor (up to 0.81 SF-36 Physical functioning at follow-up). All scales showed improvements, with effect sizes ranging from 0.16–0.67. Conclusions Our results confirm previous findings that the chronic low back pain syndrome is highly multifactorial and comprises many more dimensions of health and quality of life than merely back-related functioning. A comprehensive outcome measurement should include the predominant psychosocial domain and a broad spectrum of measurement constructs in order to assess the full complexity of the chronic low back syndrome. Convergence and divergence of the scales capture the overlapping contents and nuances within the constructs.

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Assessing Psycho-social Barriers to Rehabilitation in Injured Workers with Chronic Musculoskeletal Pain: Development and Item Properties of the Yellow Flag Questionnaire (YFQ)

Cited by 4 publications

References 46 publications

Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review

Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review

Cross-cultural adaptation and validation of the Turkish Yellow Flag Questionnaire in patients with chronic musculoskeletal pain

Comprehensiveness and validity of a multidimensional assessment in patients with chronic low back pain: a prospective cohort study

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