Abstract

Background: The biopsychosocial model shows that chronic low back pain (CLBP) is maintained by physical, psychological, and social factors, necessitating comprehensive assessment tools. The Back Bournemouth Questionnaire (BBQ), a validated seven-item measure, has been adapted into multiple languages; however, there is no Gujarati version available for India’s large linguistic community. Objective: To cross-culturally adapt the Back Bournemouth Questionnaire into Gujarati (BBQ-G) and evaluate its psychometric properties in adults with CLBP. Methods: We conducted a two-phase methodological study. Phase I involved crosscultural adaptation following Beaton et al.’s five-step guidelines. Phase II assessed psychometric properties in 150 Gujarati-speaking adults (aged 25–60 years) with confirmed CLBP. Content validity was evaluated using a 20-expert panel. Internal consistency (Cronbach’s alpha), test-retest reliability (intraclass correlation coefficient; n=30, 48-hour interval), and agreement (Bland–Altman analysis) were determined. Construct validity was assessed via Pearson’s correlations with the Numerical Pain Rating Scale (NPRS), Fear-Avoidance Beliefs QuestionnaireGujarati (FABQ-G), Roland-Morris Disability Questionnaire-Gujarati (RMDQ-G), and Patient Health Questionnaire-9-Gujarati (PHQ-9-G). Exploratory factor analysis was used to examine the underlying structure. Results: The BBQ-G demonstrated excellent content validity (S-CVI/Ave=0.95; I-CVI: 0.80-1.00), good internal consistency (Cronbach’s alpha=0.82), and acceptable test-retest reliability (ICC=0.820; 95% CI: 0.656-0.910). Bland-Altman analysis revealed minimal bias (mean difference=-0.53; limits of agreement: -11.90 to 10.83), and the minimal detectable change at the 95% confidence level (MDC95) was approximately 12 points. Significant moderate-to-strong correlations were identified with the NPRS (r=0.679), PHQ-9-G (r=0.495), FABQ-G (r=0.431), and RMDQ-G (r=0.415; all p<0.001). EFA yielded a single dominant component (eigenvalue=4.272) explaining 61.03% of the total variance (KMO=0.839). Conclusion: The BBQ-G is a reliable, valid, and culturally appropriate biopsychosocial instrument for assessing chronic low back pain in Gujaratispeaking adult and is suitable for both clinical practice and research.

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