BACKGROUND Pain-related fear-avoidance (FA) is a common problem affecting many patients with painful medical conditions. As there is great interest in the clinical importance of the relationship between FA and disability, several questionnaires have been developed to measure FA. The Fear-Avoidance Components Scale (FACS) is a recently developed patient-reported instrument that addresses critical issues not previously considered in previous FA-related questionnaires. The original English version of the FACS demonstrated good reliability, internal consistency, and construct, criterion, and predictive validity. Two factors were determined: General Fear Avoidance and Types of Activities That are Avoided. The aim of this study was to to translate the FACS into European-style Spanish (FACS-Sp), and validate its psychometric properties. METHODS This two-stage psychometric study included 330 subjects with various chronic musculoskeletal pain disorders. An initial translation and cross-cultural adaptation of the FACS, from English to Spanish, was performed. Then, critical psychometric properties were analysed, including internal consistency by Cronbach's α coefficients, structural validity from the Maximum Likelihood Extraction (MLE), and convergent validity by Pearson correlation with the Central Sensitization Inventory (CSI). RESULTS This study reports for the first time the psychometric properties of the Spanish version of the FACS. Total scores ranged from 0 to 88 points, with a mean of 30.49 (±17.18). The FACS-Sp showed a high internal consistency for factor 1 (α = 0.902) and factor 2 (α = 0.88). Factor structure was two-dimensional and supported structural validity, accounting for 48.75% of the total variance. Convergent validity analysis found a significant Pearson correlation r = 0.414. CONCLUSION This study reports for the first time the psychometric properties of the Spanish version of the FACS-Sp. Psychometric properties supported the validation of FACS-Sp and ensured the conceptual equivalence with the original English version. In primary care and chronic pain rehabilitation, FA assessment is crucial for clinical decision-making and treatment guidance. The FACS-Sp offers a new measure of FA in Spanish speaking populations. Future research on the FACS-Sp should evaluate test-retest reliability, treatment responsiveness and psychometric comparisons with other translated versions.

中文翻译：

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西班牙恐惧回避成分量表的跨文化适应和有效性以及初级保健的临床意义。

背景技术与疼痛相关的恐惧回避（FA）是影响许多患有痛苦医疗状况的患者的常见问题。由于人们对 FA 与残疾之间关系的临床重要性非常感兴趣，因此开发了几种问卷来测量 FA。恐惧回避成分量表 (FACS) 是一种最近开发的患者报告工具，它解决了之前 FA 相关问卷中未考虑到的关键问题。FACS 的英文原版表现出良好的可靠性、内部一致性以及结构、标准和预测有效性。确定了两个因素：一般恐惧避免和避免的活动类型。本研究的目的是将 FACS 翻译成欧洲风格的西班牙语 (FACS-Sp)，并验证其心理测量特性。方法 这项两阶段心理测量研究包括 330 名患有各种慢性肌肉骨骼疼痛疾病的受试者。对 FACS 从英语到西班牙语进行了初步翻译和跨文化改编。然后，分析了关键的心理测量特性，包括克朗巴赫 α 系数的内部一致性、最大似然提取 (MLE) 的结构有效性，以及皮尔逊与中央敏感化量表 (CSI) 相关性的收敛有效性。结果 这项研究首次报告了西班牙版 FACS 的心理测量特性。总分范围为 0 至 88 分，平均分为 30.49 (±17.18)。FACS-Sp 显示因子 1 (α = 0.902) 和因子 2 (α = 0.88) 具有较高的内部一致性。因子结构为二维结构，支持结构效度，占总方差的48.75%。收敛效度分析发现显着的 Pearson 相关性 r = 0.414。结论 这项研究首次报告了西班牙版 FACS-Sp 的心理测量特性。心理测量特性支持 FACS-Sp 的验证，并确保概念与原始英文版本的等效性。在初级保健和慢性疼痛康复中，FA 评估对于临床决策和治疗指导至关重要。FACS-Sp 为西班牙语人群提供了一种新的 FA 测量方法。FACS-Sp 的未来研究应评估重测可靠性、治疗反应性以及与其他翻译版本的心理测量比较。