The development and measurement properties of the Dutch version of the fear-avoidance component scale (FACS-D) in persons with chronic musculoskeletal pain.

Introduction: The Fear-Avoidance Components Scale (FACS) has been developed within the framework of the most current fear-avoidance model.1 This study aimed to translate the FACS into Dutch, and to investigate its measurement properties in patients with chronic musculoskeletal pain. Methods: The original English FACS was translated in Dutch through forward-backward translation. The FACS-D's measurement properties were evaluated in 224 persons with chronic musculoskeletal pain. Internal consistency, test-retest reliability and measurement error were assessed with the Cronbach's alpha coefficient (a), intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable change (SDC). Construct validity (including structural validity and hypothesis testing) was assessed through inter-item correlation analyses, exploratory factor analysis and by examining relationships between the FACS-D and other patient-reported instruments. Results: Internal consistency and test-retest reliability were high (a = 0.92; ICC = 0.92), and the SEM was 5.6 points. Regarding structural validity, low inter-item correlations were found for item 12. A two-factor model was found to best fit the data: one factor covered pain-related cognitions and emotions, the second factor covered items regarding avoidance behaviour. Five out of seven of the a priori-formulated hypotheses were confirmed. Discussion: The FACS-D has good reliability and validity, and can be used to evaluate fear-avoidance in persons with chronic musculoskeletal pain. It's a two-dimensional scale that assesses two clinically relevant constructs of fear-avoidance behaviour. One factor covers pain-related cognitions and emotions, while the other factor covers avoidance behaviour. Process evaluation: Notwithstanding the sound methodology, the paper's content is considered of low priority by editors. [ABSTRACT FROM AUTHOR]