The Bournemouth Questionnaire

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Objective[1][2]

The Bournemouth questionnaire (BQ) is a short, self-report questionnaire, developed by J.

Bolton.
The questionnaire exists in two different versions. The first version measures different
dimensions in patients with low back pain, whereas the second one was developed to assess
pain in patients suffering from non specific neck pain (The Neck Bournemouth
Questionnaire).

A lot of questionnaires which concentrate on pain and disability in patients with low back
pain and neck pain already existed. However, since other dimensions are also involved with
musculoskeletal pain, the BQ was developed. The development was based on the dimensions
of the ICF, which means that, next to the pain and disability, it also takes the affective and
cognitive aspects of neck pain and low back pain in account.

Both versions of the questionnaire consist of seven core items, which are: pain intensity,
function in activities of daily living, function in social activities, anxiety, depression levels,
fear avoidance behavior and locus of control behavior. The only difference between the
questionnaire for low back pain and the Neck BQ is the subscript in the item ‘activities of
daily living’. The items “walking”, “climbing stairs” and “getting in/out of bed”, described in
the Back BQ, where modified to “lifting”, “reading” and “driving” in the Neck BQ.

Intended Population

The questionnaire was developed for patients suffering from non specific low back pain or
non specific neck pain.
Larsen and leboeuf (2005) indicated that the questionnaire is not useful in patients with
persistent low back pain.[3]

Method of Use [2]

Both the questionnaires are used in the same way. Completing the test takes about 5 minutes.
The questionnaires exist of 7 questions which contain the different dimensions of the ICF.
Each item is rated on a numeric rating scale (NRS) from 0 to 10:
0= Much better
5= no change
10= much worse.
A total score on 70 can be calculated, in which a higher score reflects more complains.

Reference

Evidence
Reliability [1][4]

Homogeneity or internal consistency: It is important for a questionnaire that all the items
measure different aspects of the disease; in order to enable computing a total score by
summing up all items. The items should all correlate with each other and every item also
needs to correlate with the total score.
A Chronbach’s α of 0.90 was found for both questionnaires, consequently the BQ can be
considered a reliable instrument. Furthermore, this indicates that all of the items contribute to
the total score.

Test-retest reliability can be tested by using the intra class correlation coefficient (ICC).
This coefficient compares scores on a test that was completed by a person at two different
moments.
The ICC in the BQ for back pain patients approached 0,9 for the 3 moments (Pre-,
posttreatment and retest), indicating a strong correlation between the total scores in the
patients.
In the Neck BQ, the ICC amounted 0,65, which indicates a moderate agreement between total
scores in these patients.

Validity [1][4]

An instrument is considered to be valid when it measures what it is supposed to measure.

- Content validity: Indicates in which degree a questionnaire covers the aspects of the
measured attribute.[5]
- External construct validity: describes the degree in which a measure is related to other
measures in a questionnaire. Each of the items can be compared to the items of another
questionnaire or against the whole questionnaire. [5]

The BQ for low back pain

To determine the external construct validity, the BQ was tested against:
- Chronic Pain Questionnaire(CPQ)
- Revised Oswestry Disability Questionnaire (RODQ)
- Modified Somatic Pain Questionnaire (MSPQ)
- Fear Avoidance Beliefs Questionnaire (FABQ)
- Pain Locus of Control questionnaire (PLC)

Correlation of BQ with CPQ RODQ PLC MSPQ FABQ

Pearson’s r 0,77 0,78 0,40 0,36 0,32
The seven items where compared to the CPQ, MSPQ, RODQ, FABQ,zung and PLC.
The comparisation showed a correlation between 0,24 and 0,79. All items showed a
significant correlation with their counterpart measure, which means that the test can be
considered valid.

The Neck BQ
To determine the external construct validity, the BQ was tested against the CNFDS and the
NDI:

NDI CNFDS
Pretreatment: 0,51 0,63
Posttreatment: 0,71 0,48

The seven items where compared to the NFDS, SF36 and NDI. With a pretreatment
correlation between 0,37 - 0,62 and a posttreatment correlation between 0,44 and 0,83.
All items showed a good correlation with their counterpart measure.

Responsiveness

The responsiveness or sensitivity is the ability of a questionnaire to detect clinically

important changes over time.

The sensitivity to change can be measured by the ‘Standardized response mean’ (SRM). The
SRM calculates the relative magnitude of the mean change compared to the variability of the
changes.
A higher SRM indicates a greater sensitivity to change, SRM under the level of 0,5 indicates
no sensitivity to change. The Neck BQ showed a SRM of 1,17,which means that the
questionnaire had a good sensitivity to changes.[6]
The SRM of the BQ for low back pain was 0,78, which means that this questionnaire is less
sensitive to changes than the Neck BQ, but can still find significant changes of treatment.[7]

Internal longitudinal construct validity: Internal responsiveness of individual items of the

questionnaire. The correlation should be 0,3 or higher to make sure that each item contributes
significantly to the total responsiveness of the test.

In the BQ for low back pain all of the 7 items showed a correlation greater than 0,56. In the
Neck BQ all of the items obtained a correlation greater than 0,42.[1] [4]
This indicates that all the items where significant, which means that each item is individually
responsive to clinical significant changes. Furthermore, each item contributes significantly to
the change in the total score.

Bolton et al (2004) indicated that an improvement of 13 points on the total score or a

percentage change score of 36% was associated with clinically significant improvement. [6]

Miscellaneous

Links
View the Neck Bournemouth Questionnaire

View the Bournemouth Questionnaire for low back pain

Recent Related Research (from Pubmed)

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References
References will automatically be added here, see adding references tutorial.

1.

 Bolton J., Humphreys B., The Bournemouth Questionnaire: a short form comprehensive
outcome measure. II. Psychometric properties in neck pain patients. Journal of manupilative
andphysiological therapeutics, 2002.(A2)
  Gay R., Madson T., Cieslak K., Comparison of the neck disability index and the neck
Bournemouth questionnaire in a sample of patients with chronic uncomplicated neck pain.
Journal of manipulative and physiological therapies, 2007.(B)
 Larsen K., Leboeuf C., The Bournemouth Questionnaire, Can it be used to monitor and
predict treatment outcome in chiropra
 Bolton J., Humphreys B., The Bournemouth Questionnaire: a short form comprehensive
outcome measure. I. Psychometric properties in back pain patients. Journal of manupilative
andphysiological therapeutics, 1999.(A2)
  Liebenson G., Rehabilitation of the spine, Williams and Wilkins, 1996
  Bolton J., Sensitivity and specificity of outcome measures in patients witch neck pain:
Detecting clinically significant improvement. Spine, 2004.(C)
 Perillo M., Bulbulian R., Responsiveness of the Bournemouth Questionnaire and Oswestry
Questionnaire: A prospective pilot study. Journal of manipulative and psychological
therapeutics, 2003.(C)
Kuesioner Bournemouth
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untuk siswa dalam program Rehabilitasi Ilmu Pengetahuan dan Fisioterapi Vrije Universiteit Brussel,
Brussels, Belgia. Tolong jangan edit kecuali jika Anda terlibat dalam proyek ini, tapi tolong kembalilah
dalam waktu dekat untuk memeriksa informasi baru !!
Tujuan [1] [2]

Kuesioner Bournemouth (BQ) adalah kuesioner laporan singkat dan singkat, yang dikembangkan
oleh J. Bolton.
Kuesioner itu ada dalam dua versi yang berbeda. Versi pertama mengukur dimensi yang berbeda
pada pasien dengan nyeri punggung bawah, sedangkan yang kedua dikembangkan untuk menilai
rasa sakit pada pasien yang menderita nyeri leher tidak spesifik (The Neck Bournemouth
Questionnaire).

Banyak kuesioner yang berkonsentrasi pada rasa sakit dan kecacatan pada penderita sakit punggung
bawah dan sakit leher sudah ada. Namun, karena dimensi lain juga terlibat dengan nyeri
muskuloskeletal, BQ dikembangkan. Perkembangannya didasarkan pada dimensi ICF, yang berarti, di
samping rasa sakit dan cacat tubuh, juga dibutuhkan aspek afektif dan kognitif nyeri leher dan nyeri
punggung bawah.

Kedua versi kuesioner terdiri dari tujuh item inti, yaitu: intensitas nyeri, fungsi dalam aktivitas
kehidupan sehari-hari, fungsi dalam aktivitas sosial, kecemasan, tingkat depresi, perilaku
menghindari rasa takut dan perilaku lokus kontrol. Satu-satunya perbedaan antara kuesioner untuk
nyeri punggung bawah dan Leher Leher adalah subskrip dalam aktivitas item 'kehidupan sehari-hari'.
Item "berjalan", "menaiki tangga" dan "masuk / tidur dari tempat tidur", dijelaskan di Back BQ, yang
diubah menjadi "lifting", "reading" dan "driving" di Neck BQ.
Populasi yang dituju

Kuesioner dikembangkan untuk pasien yang menderita nyeri punggung bawah yang tidak spesifik
atau nyeri leher yang tidak spesifik.
Larsen dan leboeuf (2005) menunjukkan bahwa kuesioner tersebut tidak berguna pada pasien
dengan nyeri punggung bawah yang persisten. [3]
Metode Penggunaan [2]

Kedua kuesioner tersebut digunakan dengan cara yang sama. Melengkapi tes memakan waktu
sekitar 5 menit.
Kuesioner ada dari 7 pertanyaan yang mengandung dimensi berbeda dari ICF.
Setiap item diberi nilai pada skala penilaian numerik (NRS) dari 0 sampai 10:
0 = Jauh lebih baik
5 = tidak ada perubahan
10 = jauh lebih buruk
Skor total 70 dapat dihitung, di mana skor yang lebih tinggi mencerminkan lebih banyak keluhan.
Referensi
Bukti
Keandalan [1] [4]

Homogenitas atau konsistensi internal: Penting bagi kuesioner bahwa semua item mengukur aspek
penyakit yang berbeda; untuk memungkinkan menghitung total skor dengan menjumlahkan semua
item. Item semua harus berkorelasi satu sama lain dan setiap item juga perlu berkorelasi dengan
total skor.
A Chronbach α 0,90 ditemukan untuk kedua kuesioner, oleh karena itu BQ dapat dianggap sebagai
instrumen yang andal. Selanjutnya, ini menunjukkan bahwa semua item berkontribusi terhadap total
skor.

Uji reliabilitas uji coba dapat diuji dengan menggunakan koefisien korelasi intra kelas (ICC).
Koefisien ini membandingkan skor pada tes yang diselesaikan oleh seseorang pada dua momen yang
berbeda.
ICC di BQ untuk pasien nyeri punggung mendekati 0,9 untuk 3 momen (Pra, posttreatment dan tes
ulang), menunjukkan korelasi kuat antara skor total pada pasien.
Di BQ Leher, ICC berjumlah 0,65, yang mengindikasikan adanya kesepakatan moderat antara jumlah
skor pada pasien tersebut.
Validitas [1] [4]

Instrumen dianggap valid saat mengukur ukuran yang seharusnya diukur.

- Validitas isi: Menunjukkan tingkat kuesioner yang mencakup aspek atribut yang diukur. [5]
- Validitas konstruk eksternal: menggambarkan tingkat di mana ukuran terkait dengan tindakan lain
dalam kuesioner. Masing-masing item dapat dibandingkan dengan item kuesioner lain atau terhadap
keseluruhan kuesioner. [5]

BQ untuk nyeri punggung bawah

Untuk menentukan validitas konstruk eksternal, BQ diuji terhadap:
- Chronic Pain Questionnaire (CPQ)
- Kuesioner Cacat Disabilitas yang Direvisi (RODQ)
- Modifikasi Somatic Pain Questionnaire (MSPQ)
- Ketidakpastian Keyakinan Penalaran Kuesioner (FABQ)
- Pain Locus of Control questionnaire (PLC)
Korelasi BQ dengan CPQ RODQ PLC MSPQ FABQ
Pearson's r 0,77 0,78 0,40 0,36

0,32

Tujuh item di mana dibandingkan dengan CPQ, MSPQ, RODQ, FABQ, zung dan PLC.
Komparasi menunjukkan korelasi antara 0,24 dan 0,79. Semua item menunjukkan korelasi yang
signifikan dengan ukuran rekan kerja mereka, yang berarti bahwa tes tersebut dapat dianggap valid.

BQ Leher
Untuk menentukan validitas konstruk eksternal, BQ diuji terhadap CNFDS dan NDI:
NDI CNFDS
Pretreatment: 0,51

0,63
Posttreatment: 0,71 0,48

Tujuh item di mana dibandingkan dengan NFDS, SF36 dan NDI. Dengan korelasi pretreatment antara
0,37 - 0,62 dan korelasi posttreatment antara 0,44 dan 0,83.
Semua item menunjukkan korelasi yang baik dengan ukuran rekannya.
Resp