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Pain-Related Fear in Adults Living With Chronic Pain: Development and Psychometric Validation of a Brief Form of the Tampa Scale of Kinesiophobia

  • Etienne J. Bisson
    Correspondence
    Corresponding author Etienne J. Bisson, PhD, Kingston Health Sciences Centre, Jeanne Mance 3, Hotel Dieu Hospital Site, 166 Brock Street, Kingston ON Canada K7L 3G2.
    Affiliations
    Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Canada

    School of Rehabilitation Therapy, Queen's University, Kingston, Canada

    Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Canada

    Centre for Neuroscience Studies, Queen's University, Kingston, Canada
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  • Laura Katz
    Affiliations
    Michael G. DeGroote Pain Clinic, McMaster University, Hamilton, Canada
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  • Kyle Vader
    Affiliations
    Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Canada

    School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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  • Jennifer A. Bossio
    Affiliations
    Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Canada

    School of Medicine, Queen's University, Kingston, Canada
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  • Rosemary Wilson
    Affiliations
    Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Canada

    School of Nursing, Queen's University, Kingston, Canada
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  • Scott Duggan
    Affiliations
    Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, Canada

    Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Canada

    Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
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Published:October 01, 2021DOI:https://doi.org/10.1016/j.apmr.2021.09.001

      Highlights

      • A 2-factor structure TSK-11 was confirmed in a large mixed chronic pain population.
      • Two brief TSK versions (TSK-7 and TSK-5) had similar psychometrics compared with TSK-11.
      • Both TSK-7 and TSK-5 total scores and subscales had good convergent validity.

      Abstract

      Objective

      To develop and validate a brief version of the Tampa Scale of Kinesiophobia (TSK) while preserving content validity in a mixed chronic pain population.

      Design

      Cross-sectional study.

      Setting

      Tertiary care interdisciplinary chronic pain clinic.

      Participants

      Adults with chronic pain (N=933; mean age, 53.5±15.7 years; 63% women).

      Intervention

      Not applicable.

      Main Outcome Measure

      TSK-11 measured at intake. Self-reported data from a patient registry were extracted from November 2017 to October 2019.

      Results

      An exploratory factor analysis identified a 2-factor structure from the TSK-11 and item reduction resulted in a 7-item TSK (TSK-7) with 61.2% explained variance and Cronbach's alphas of 0.76 and 0.70 for each of the 2 factors. To maximally reduce the number of items without affecting internal consistency, a 5-item TSK (TSK-5) with 72% explained variance was also explored. Strong correlations were found between the newly developed brief TSK versions and TSK-11 (r>0.93), suggesting good concurrent validity. TSK-11, TSK-7, and TSK-5 had similar convergent validity with moderate correlations for pain catastrophizing (r=0.57, 0.58, 0.54), depression (r=0.45, 0.46, 0.42), pain interference (r=0.43, 0.44, 0.40), and pain acceptance (r=–0.57, –0.59, –0.55).

      Conclusions

      These 2 brief versions of the TSK may help to simplify questionnaires across chronic pain centers where multiple outcome measures are used for a complete biopsychosocial assessment of patients.

      Keywords

      List of abbreviations:

      AA (activity avoidance), BPI (Brief Pain Inventory Short Form), CPAQ-8 (Chronic Pain Acceptance Questionnaire–8-item short form), EFA (exploratory factor analysis), KHSC (Kingston Health Sciences Centre), PCS-6 (Pain Catastrophizing Scale–6-item short form), SF (somatic focus), SF-12 (Short Form 12-item Health Survey), TSK (Tampa Scale of Kinesiophobia)
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