Cross-Cultural Adaptation, Reliability, and Validity of the Chinese Version of the Tampa Scale for Kinesiophobia-11 Among Patients Who Have Undergone Total Knee Arthroplasty

Libai Cai; Yanjin Liu; Steve R Woby; Namassevayam Genoosha; Miaoran Cui; Lina Guo

doi:10.1016/j.arth.2019.01.076

Cross-Cultural Adaptation, Reliability, and Validity of the Chinese Version of the Tampa Scale for Kinesiophobia-11 Among Patients Who Have Undergone Total Knee Arthroplasty

J Arthroplasty. 2019 Jun;34(6):1116-1121. doi: 10.1016/j.arth.2019.01.076. Epub 2019 Feb 6.

Authors

Libai Cai¹, Yanjin Liu¹, Steve R Woby², Namassevayam Genoosha³, Miaoran Cui¹, Lina Guo¹

Affiliations

¹ Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
² Department of Research & Innovation, Salford Royal NHS Foundation Trust & School of Health Sciences, University of Salford, Salford, England.
³ Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Supplementary Health Sciences, Faculty of Health Care Sciences, Eastern University, Chenkalady, Sri Lanka.

PMID: 30853160
DOI: 10.1016/j.arth.2019.01.076

Abstract

Background: The shortened version of the Tampa Scale for Kinesiophobia (TSK-11) has been well characterized in the literature. However, to the best of our knowledge, no previous studies have evaluated the reliability and validity of the TSK-11 for Chinese-speaking patients who have undergone total knee arthroplasty (TKA). Thus, the objectives of this study were to translate and adapt the TSK-11 cross-culturally into Chinese and to evaluate its reliability and validity in a sample of Chinese TKA patients.

Methods: The TSK-11 was translated and cross-culturally adapted into Chinese according to the international guidelines for the cross-cultural adaptation of self-report measures. The Chinese version of TSK-11 was administered to 254 patients following their TKA, along with the Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, Numerical Rating Scale, and 12-Item Short Form Health Survey. Psychometric testing included internal consistency, test-retest reliability, floor and ceiling effects, construct validity, and convergent validity.

Results: A high completion rate of 95.8% with no floor or ceiling effects was noted in the Chinese version of the TSK-11. The questionnaire also showed good internal consistency (Cronbach's α = 0.883) and test-retest reliability (intraclass correlation coefficient = 0.798). Construct validity was assessed by exploratory factor analysis, and 3 factors were extracted that accounted for 65.2% of the variance. Convergent validity was confirmed by significant Pearson correlations between the Chinese version of the TSK-11 and the Pain Catastrophizing Scale (r = 0.751), Fear-Avoidance Beliefs Questionnaire (r = 0.719) and VAS (r = 0.450), as well as the 12-Item Short Form Health Survey subdomains Bodily Pain (r = -0.391), Mental Health (r = -0.356), Physical Functioning (r = -0.339), Role-Emotional (r = -0.317), and Role-Physical (r = -0.277).

Conclusion: The Chinese version of the TSK-11 demonstrated satisfactory acceptability, reliability, and validity; therefore, it can be used in clinical practice and research for assessing kinesiophobia in Chinese patients after TKA.

Keywords: Tampa Scale for Kinesiophobia (TSK); fear of movement; kinesiophobia; reliability; total knee arthroplasty (TKA); validity.

MeSH terms

Adult
Aged
Arthroplasty, Replacement, Knee*
Avoidance Learning
China
Cross-Cultural Comparison
Cultural Characteristics
Fear
Female
Humans
Male
Middle Aged
Orthopedics / methods
Pain
Pain Measurement*
Phobic Disorders / diagnosis*
Postoperative Complications / diagnosis*
Postoperative Complications / psychology*
Psychometrics / methods
Reproducibility of Results
Self Report
Surveys and Questionnaires
Treatment Outcome