Development of the Young Disability Questionnaire (spine) for children with spinal pain: field testing in Danish school children

Abstract

Objective: The objective of this study was to finalise the development of the Young Disability Questionnaire (YDQ-spine) to measure the consequences of neck, midback and low back pain, relevant for schoolchildren aged 9-12 years.

Design: A cross-sectional field test of the YDQ-spine was carried out.

Setting: Danish primary schools.

Participants: Children aged 9-12 years from all Danish schools were invited to complete the questionnaire.

Methods: Eight hundred and seventy-three schools were invited to participate. Consenting schools received information material, instructions and a link to an electronic version of the prefinal YDQ-spine. Local teachers distributed the electronic YDQ-spine to children aged 9-12 years. Descriptive statistics and item characteristics were carried out. Item reduction was performed using partial interitem correlations (scrutinising correlations>0.3) and factor analyses (items loading>0.3 were retained) to eliminate redundant items and to obtain insight into the structure of the questionnaire.

Results: A total of 768 children from 20 schools answered of the questionnaire and 280 fulfilled the inclusion criteria of having back and/or neck pain (36%). Multisite pain was reported by 38%. Partial interitem correlations and factor analyses resulted in elimination of four items which were considered redundant leaving 24 items in the final YDQ-spine with an optional section on what matters most to the child. The factor analyses showed a two-factor structure with a physical component (13 items) and a psychosocial component (10 items) in addition to one standalone item (sleep).

Conclusion: The YDQ-spine is a novel questionnaire with satisfactory content validity measuring physical and psychosocial components (including sleep disturbances) of spinal pain in children aged 9-12 years. It also offers an optional section on what matters most to the child allowing targeted care in clinical practice.

Keywords: back pain; paediatrics; pain management; rehabilitation medicine.

Figure 1

The inclusion of children in the study. Section 1, prevalence and pain intensity estimates from the Young Spine questionnaire; Section 2, newly developed consequences of spinal pain items. *rFPS, revised Faces Pain Scale.

Figure 2

Distribution of responses and missing scores of the four questions about ‘What matters most to the children’. The question asked was: ‘The worst thing about having pain in my neck, middle back or lower back is…’. The response scale of the four questions was an 11-box numeric rating scale ranging from ‘It doesn’t matter at all’ to ‘It matters a lot’ (X-axis). Total number of answered questionnaires=275.

Figure 3

Screeplot of the 28 questions about consequences of spinal pain. The horizontal line corresponds to a cut-off eigenvalue=1. The number of factors was arbitrarily cut at 14 to avoid cluttering of the graph.