The applicability of the Tampa Scale of Kinesiophobia for patients with sub-acute neck pain: a qualitative study

The purpose of this study was to qualitatively evaluate patients understanding and interpretation of the wording used in test items of the Tampa Scale of Kinesiophobia (TSK). The TSK was developed to measure fear of movement in patients suffering from low back pain. The TSK is being increasingly used for other pain conditions. Patients with sub-acute neck pain experience problems while completing this questionnaire. The aim of this study was to elicit these problems. The study was conducted within the framework of a randomised controlled trial. The Three-Step Test Interview (TSTI) was used to collect data on the thoughts or considerations of respondents while completing the TSK. In the analysis, each transcribed interview was divided into three segments. The thoughts and considerations were then analysed and categorised per item. During the TSTI two problems were identified. One concerned the meaning of specific words used, like "dangerous" and "injury". The other problem was that several implicit assumptions within some items make it difficult for respondents to answer these items. It was concluded that in the development and validation of questionnaires like the TSK, not only quantitative psychometric properties are important, but also qualitative research has an important contribution to enhance applicability.