What can I do for my low back pain? The Work In Progress questionnaire!

Background: There is growing evidence on Commitment Therapy for people with low back pain (LBP). A self-reported questionnaire is lacking which evaluates commitment by relying on the most recommended actions, the most important core outcome domains, and the most evidenced treatment options.

Aim: To describe the development and psychometric validation of the Work In Progress (WIP) questionnaire.

Design: Development and psychometric validation of the WIP questionnaire in the context of people with LBP, as a means to evaluate Commitment.

Setting: Outpatient facilities.

Population: People with LBP.

Methods: The new instrument was created by item generation and selection. Face validity, appropriateness, acceptability and feasibility were investigated. Psychometric testing was carried out in a cross-sectional study and included: 1) exploratory factor analysis; 2) reliability by internal consistency (Cronbach's alpha) and test-retest measurement (Intra-class Correlation Coefficient, ICC2.1); and 3) construct validity by hypothesis testing the correlation of the WIP questionnaire with the Pain Catastrophizing Scale (PCS), the Oswestry Disability Index (ODI), and a pain intensity Numerical Rating Scale (NRS) (Pearson's r correlations).

Results: The WIP questionnaire was successfully developed based on international guidelines and the testing of face validity, appropriateness, acceptability and feasibility were satisfactory. The instrument was administered to 102 people with LBP (39 females, mean age of 49.7±14.6 years [range 20-80], pain median duration of 42.1 weeks [range 3-360]). Factor analysis revealed a two-factor 10-item solution (57% of explained variance). The internal consistency was good (α=0.70-85) and test-retest assessment was excellent (ICC2.1=0.91-94). Construct validity was good, as ≥75% of hypotheses were confirmed.

Conclusions: The WIP questionnaire is a self-reported tool to evaluate commitment in persons with LBP showing satisfactory psychometric properties. It can be recommended for clinical and research purposes.

Clinical rehabilitation impact: This study adds original new data to the existing knowledge in the field of Commitment within the bio-psychosocial paradigm for disabled people. It is expected to contribute to the evaluative, clinical and rehabilitative approach of individuals with low back pain.