Translation and initial psychometric evaluation of the Danish version of the treatment expectation questionnaire (TEX-Q).

Abstract

Background: Patient expectations are important psychological determinants of health outcomes. The Treatment Expectation Questionnaire (TEX-Q) is a validated, multidimensional instrument for assessing treatment expectations; however, no Danish version has previously been available. This study aimed to translate and conduct an initial psychometric evaluation of a Danish version of the TEX-Q in patients undergoing spinal surgery.

Methods: The TEX-Q was translated using a structured forward-backward procedure in accordance with ISPOR guidelines, including expert review by clinicians from different professional backgrounds. Consecutive adult patients scheduled for spinal surgery at a university hospital were invited to participate. The initial psychometric evaluation followed established PROM reporting standards and included assessment of feasibility, internal consistency, test-retest reliability, floor and ceiling effects, and construct validity.

Results: The Danish TEX-Q demonstrated high comprehensibility and linguistic clarity, with mean item ratings ranging from 5.4 to 5.8 on a six-point Likert scale. Reliability varied across domains, with good internal consistency and test-retest reliability observed for most domains. Floor effects were negligible, while ceiling effects exceeded 15% in selected domains. Construct validity analyses showed no association between the TEX-Q total score and functional disability, while only limited domain-specific associations were observed, and a small but statistically significant positive association with quality of life.

Conclusion: The Danish version of TEX-Q was successfully translated and demonstrated promising initial psychometric properties in a population of patients undergoing spinal surgery. However, variability in reliability across domains warrants cautious interpretation of domain-level results. Further studies are needed to assess structural validity and confirm the psychometric properties of the instrument in larger and more diverse clinical populations.