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

Abstract

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.

Ergonomic risks and musculoskeletal pain in hospital cleaning workers: Convergent Care Research with mixed methods

“…Furthermore, in the perception of SHL workers, ergonomic risk and MSP were influenced by the psychosocial aspects of work. In this case, ergonomic risks are not limited to frequent mechanical exposures, unfavorable body postures and the use of equipment, but organizational, psychological and social issues can also constitute risk factors for MSP ( 6 , 32 ) .…”

“…Therefore, risks, aspects or psychosocial factors exist from the interaction between the workplace, organizational and environmental conditions, skills and individual needs of the worker ( 32 - 33 ) . These contacts can lead to tension (high demand and low level of control), stress, lack of recognition, social devaluation of work, loss of motivation and engagement, gender inequality and lack of social support, depending on the way cleaning workers experience them ( 6 , 33 ) .…”

“…These contacts can lead to tension (high demand and low level of control), stress, lack of recognition, social devaluation of work, loss of motivation and engagement, gender inequality and lack of social support, depending on the way cleaning workers experience them ( 6 , 33 ) . The type of management and leadership may or may not enhance these negative effects on performance, job satisfaction and health, especially regarding the risk of MSP ( 32 - 33 ) .…”

“…In the meantime, psychosocial risk factors are related to a worse perception of health, and early detection becomes crucial for the management of MSP. They are considered “yellow flags”, that is, predictors of non-return to work, transition from acute to chronic pain and work incapacity, on which strategies aimed at SHL workers must focus ( 32 ) .…”