Test-retest reliability of the pain attitudes and beliefs scale and sensitivity to change in a general practitioner population.

摘要

BACKGROUND: Costs of compensated work loss for low back pain have risen dramatically. Current healthcare management of this condition may contribute to this trend. Researchers are currently investigating the degree to which healthcare practitioners' attitudes and beliefs may influence their patient management. Measures used to assess healthcare practitioners' attitudes and beliefs have often been adapted from patient tools. The degree to which they have been assessed for use with different populations varies. OBJECTIVES: To measure test-retest reliability of the Pain Attitudes and Beliefs Scale and sensitivity to detect change after a minimal intervention strategy (MIS) in general practitioners (GPs). METHODS: GPs completed up to 3 presentations of the 2-factor measure (initial, reliability, and after MIS). RESULTS: There were significant intraclass correlations between initial and reliability scores: biomedical factor (0.806) and biopsychosocial factor (0.653). Analyses revealed no systematic change for either factor between initial and reliability presentations. Ninety-four percent of biomedical and 93% of biopsychosocial scores fell between Bland and Altman 95% Limits of Agreement. Paired samples t tests suggested statistically significant differences in scores after MIS (biomedical P<0.0005 and biopsychosocial P<0.0005). Ninety-five percent smallest real difference bandwidths revealed only scores on the biomedical factor changed significantly after MIS. When analyzed separately, a subset that scored lowest on the biopsychosocial factor (< or =15) before training, did shift significantly after training. DISCUSSION: Statistical methods used suggest that the measure demonstrates good reliability with a GP population. The influence of training on attitudes and beliefs of GPs is discussed.