Fear of movement/(re)injury in Chinese patients with chronic pain: Factorial validity of the Chinese version of the Tampa Scale for Kinesiophobia

Objective: To assess the factor structure of the Chinese version of the Tampa Scale for Kinesiophobia (TSK). Design: Chinese patients with chronic pain attending either orthopaedic specialist services (n = 216) or multidisciplinary specialist pain services (n = 109) participated in this study. Methods: Subjects completed the Chinese version of TSK, The Chronic Pain Grade Questionnaire, Hospital Anxiety and Depression Scale, and questions assessing socio-demographic characteristics. Confirmatory factor analyses were used to compare hierarchical and correlated models of 5 different factor solutions previously reported in patients with chronic pain in the West. Results: Confirmatory factor analyses demonstrated inequality of the TSK factor structure, in that the TSK11 for the orthopaedics sample was best represented by a two-factor correlated model (S-Bχ2 = 49.593; comparative fit index (CFI) = 0.93; normed filt index (NFI) = 0.911; root mean square error of approximation (RMSEA) = 0.025) comprising 2 first-order factors, Somatic Focus (TSK11-SF) and Activity Avoidance (TSK-AA). The pain clinic sample showed a one-factor structure as best representing the TSK4’s underlying dimensions (CFI = 0.971; NFI = 0.912; RMSEA = 0.048). There was no evidence to support a single overarching concept of kinesiophobia. Conclusion: The TSK appears to have utility in Chinese chronic pain populations. Elucidation of the TSK’s psychometrics properties in other Chinese/Asian pain populations with different diagnoses and presentations of pain problems is warranted