Cognitive Behavior Assessment Questionnaire (CBAQ) : Psychometric properties and exploratory factor analysis

Research Objectives: 1. To develop a Cognitive Behavior Assessment Questionnaire (CBAQ)
2. To check the reliability, construct validity, and factor analysis of CBAQ.

Design: Delphi iterative survey for the development of (CBQ-NSCLBP) and validation study using convenient sampling

Setting: Dr. D.Y. Patil College of Physiotherapy, Pune, India.

Participants: Phase I -The modified Delphi method was used for gathering the responses from the thirteen experts from multiple disciplines having a minimum 5-year experience in the management of CLBP.
Phase II- Response was checked on 174 Chronic Low Back Patients.

Interventions: The questionnaire was created using a literature review, comprising 35 items based on psychological distress, pain catastrophizing, and Fear avoidance belief. The experts assessed and expressed their agreement using a five-point Likert scale ( 1 =  Strongly disagree; 2 =  Disagree; 3 =  Neither agree nor disagree; 4 =  Agree; 5 =  Strongly agree). Data were analyzed using Content Validity Index (CVI) and Content Validity ratio (CVR).

Main Outcome Measures: CVI and CVR
ICC Calculation Using Single-Rating, Absolute-Agreement, 2-Way Random-Effects Model
KMO and Bartlett's Test
Extraction

Method: Principal Component Analysis.
Rotation

Method: Promax with Kaiser Normalization.
Spearman's Correlation

Results: The ICC estimates and their 95% confidence intervals were calculated using IBM SPSS Statistics 26.0 software. The ICC values for all the items were greater than 0.9 which indicates excellent reliability. Cronbach’s alpha was equal to 0.758 which indicated acceptable reliability.
Using exploratory factor analysis, 5 factors were extracted. All the items are valid since spearman's correlation value is higher than the cutoff value (0.139). This cutoff value was based on the sample size, degree of freedom, and level of significance (0.05).

Conclusions: We have developed a tool for assessing cognitive behaviors in patients with nonspecific chronic low back pain. The
questionnaire demonstrates excellent content validity, construct validity, and responsiveness and can be effectively used to assess patients with CLBP.

Author(s) Disclosures: No conflict of interest