Validation of the Korean version of the avoidance endurance behavior questionnaire in patients with chronic pain

Abstract

BackgroundThe avoidance-endurance model suggests both fear-avoidance responses and endurance-related responses could affect the chronicity of pain. Proper pain intervention requires measuring fear-avoidance responses and endurance-related responses but no Korean language questionnaire has yet been made to measure them. The purpose of this study was to evaluate the validity and reliability of the Korean version of the Avoidance-Endurance Behavior Questionnaire (K-AEQ-Behavior) by adapting the behavioral responses of Avoidance-Endurance Questionnaire into Korean language.MethodsThe K-AEQ-Behavior was forward and backward translated based on the standards for instrument translation. A total of 136 outpatients with chronic pain of a duration exceeding 3 months were recruited from a pain center at a university hospital in Seoul, Korea. Two weeks later, the K-AEQ-Behavior was re-administered to 36 patients for test-retest reliability. Exploratory factor analysis was performed using principle axis factoring. The internal consistency, test-retest reliability, and concurrent validity of the K-AEQ-Behavior were measured by Cronbach’s ⍺, intraclass correlation coefficient, and Pearson correlation coefficient, respectively.ResultsAlthough the four-factor structure (23 items) was derived in the original study, the two-factor structure of avoidance behavior and endurance behavior (21 items) was derived in the exploratory factor analysis of the Korean version in this study. Other results indicated that K-AEQ-Behavior has good internal consistency, test-retest reliability and concurrent validity.ConclusionThis study suggests that the K-AEQ-Behavior is a reliable and valid instrument for assessing avoidance behavior and endurance behavior in patients with chronic pain.

Translation, reliability, and validity of the avoidance endurance questionnaire in Iranian subjects with chronic non-specific neck pain

“…Only three avoidance subscales were associated with fear of movement, FAB, disability, and catastrophizing and pain intensity that this was in line with An et al and Parrage et al studies and the original version of AEQ. [ 2 15 31 ] Also, other avoidance responses are positively associated with fear of movement, FAB, and catastrophizing like other studies. [ 15 31 ] The chronicity of the pain leads to a maladaptive response and subjects prefer to avoid physical activities and participating in society so it can make a “disuse syndrome” and psychological dysfunction (anxiety, depression), These results are in line with FAM of Vlaeyen and Linton.…”

“…[ 2 15 31 ] Also, other avoidance responses are positively associated with fear of movement, FAB, and catastrophizing like other studies. [ 15 31 ] The chronicity of the pain leads to a maladaptive response and subjects prefer to avoid physical activities and participating in society so it can make a “disuse syndrome” and psychological dysfunction (anxiety, depression), These results are in line with FAM of Vlaeyen and Linton. [ 1 31 ] The PMS and PPS.MP are two adaptive endurance responses that based on AEM of Hasenbring et al , these responses were associated with low disability, FAB, psychological dysfunction.…”

“…These results consisted of An et al article but the ICC which they reported was less and their study did in subjects with chronic pain (low back pain, fibromyalgia) but this study was done in subjects with CNSNP. [ 15 ] The MDC tests of all the subscales of the Persian version of AEQ assisted researchers and clinicians in finding reliable and real avoidance or endurance responses to the chronic pain. [ 32 ] The mean difference of all the subscales was between the upper and lower band of the limits of agreement (LOA), and those confirmed that there weren’t real differences between scores of test and retest day.…”

“…[ 2 ] The results showed a negative association between PMS, PPS.MP, and fear of movement and FAB that it was in line with other studies. [ 15 31 ] The TSS is a maladaptive ER that leads to “overuse syndrome” and finally disability and psychological dysfunction so it is positively related to fear of movement and Catastrophizing. [ 2 31 ] The difference between cultured and type of disorder can be causes of no association between other subscales and questionnaires.…”

“…[ 2 ] The internal consistency (α > 0.7) of all subscales is acceptable in the original version and other versions. [ 2 12 13 14 15 ] The ER subscales are related negatively to disability kinesiophobia and FAB (r = −0.234 to r = −0.495) and positively associated with pain intensity (r = 0.195 to r = 0.281). The FAR subscales are related positively to disability, kinesiophobia, and FAB (r = 0.188 to r = 0.485) and positively associated with pain intensity (r = 0.203 to r = 0.260).…”