Evidence map›Paper›PMID 35012565›Full record

ArticleHealth and quality of life outcomes2022

Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire.

Edel T O'Hagan, Ian W Skinner, Matthew D Jones, Emma L Karran, Adrian C Traeger, Aidan G Cashin, Benedict M Wand, Siobhan M Schabrun, Sean O'Neill, Ian A Harris and 1 more

Open access · goldAbstract read
In one paragraph

Article in Health and quality of life outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Edel T O'HaganCentre for Pain IMPACT, Neuroscience Research Australia (NeuRA), 139 Barker Street, Randwick, NSW, 2031, Australia. e.ohagan@neura.edu.au.ORCID http://orcid.org/0000-0002-1914-5918
Ian W SkinnerSchool of Community Health, Charles Sturt University, Port Macquarie, NSW, Australia.
Matthew D JonesCentre for Pain IMPACT, Neuroscience Research Australia (NeuRA), 139 Barker Street, Randwick, NSW, 2031, Australia.
Emma L KarranIIMPACT in Health, UniSA: Allied Health and Human Performance, The University of South Australia, Adelaide, SA, Australia.
Adrian C TraegerInstitute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Aidan G CashinCentre for Pain IMPACT, Neuroscience Research Australia (NeuRA), 139 Barker Street, Randwick, NSW, 2031, Australia.
Benedict M WandFaculty of Medicine, Nursing and Midwifery and Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia.
Siobhan M SchabrunCentre for Pain IMPACT, Neuroscience Research Australia (NeuRA), 139 Barker Street, Randwick, NSW, 2031, Australia.
Sean O'NeillSouth Western Sydney Clinical School, Liverpool Hospital, The University of New South Wales, Sydney, NSW, Australia.
Ian A HarrisInstitute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
James H McAuleyCentre for Pain IMPACT, Neuroscience Research Australia (NeuRA), 139 Barker Street, Randwick, NSW, 2031, Australia.
UNSW Sydney · AUThe University of Sydney · AUCharles Sturt University · AUNeuroscience Research Australia · AUThe University of Notre Dame Australia · AUUniversity of South Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClinician time and resources may be underutilised if the treatment they offer does not match patient expectations and attitudes. We developed a questionnaire (AxEL-Q) to guide clinicians toward elements of first-line care that are pertinent to their patients with low back pain.

methodsWe used guidance from the COSMIN consortium to develop the questionnaire and evaluated it in a sample of people with low back pain of any duration. Participants were recruited from the community, were over 18 years and fluent in English. Statements that represented first-line care were identified. Semantic scales were used to measure attitude towards these statements. These items were combined to develop the questionnaire draft. Construct validity was evaluated with exploratory factor analysis and hypotheses testing, comparing to the Back Beliefs Questionnaire and modified Pain Self-Efficacy Questionnaire. Reliability was evaluated and floor and ceiling effects calculated.

resultsWe recruited 345 participants, and had complete data for analysis for 313 participants. The questionnaire draft was reduced to a 3-Factor questionnaire through exploratory factor analysis. Factor 1 comprised 9 items and evaluated Attitude toward staying active, Factor 2 comprised 4 items and evaluated Attitude toward low back pain being rarely caused by a serious health problem, Factor 3 comprised 4 items and evaluated Attitude toward not needing to know the cause of back pain to manage it effectively. There was a strong inverse association between each factor and the Back Beliefs Questionnaire and a moderate positive association with the modified Pain Self-Efficacy Questionnaire. Each independent factor demonstrated acceptable internal consistency; Cronbach α Factor 1 = 0.92, Factor 2 = 0.91, Factor 3 = 0.90 and adequate interclass correlation coefficients; Factor 1 = 0.71, Factor 2 = 0.73, Factor 3 = 0.79.

conclusionThis study demonstrates acceptable construct validity and reliability of the AxEL-Q, providing clinicians with an insight into the likelihood of patients following first-line care at the outset.

Indexed as

Low Back PainAttitudeCross-Cultural ComparisonHumansPsychometricsQuality of LifeReproducibility of ResultsSurveys and QuestionnairesFirst-line careLow back painMeasurement propertiesQuestionnaire development

Identifiers

PMID35012565
PMCPMC8744221
OpenAlexW4205758385

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.