Fear Avoidance Beliefs Questionnaire (FABQ)

Psychiatry
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FEAR AVOIDANCE BELIEFS QUESTIONNAIRE (FABQ)

Name: [text] Date: [date]
Here are some of the things which other patients have told us about their pain. For each statement please circle any number from 0 to 6 to say how much physical activities such as bending, lifting, walking or driving affect or would affect your back pain.

[select name="Q1" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 1. My pain was caused by physical activity
[select name="Q2" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 2. Physical activity makes my pain worse
[select name="Q3" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 3. Physical activity might harm my back
[select name="Q4" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 4. I should not do physical activities which (might) make my pain worse
[select name="Q5" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 5. I cannot do physical activities which (might) make my pain worse

The following statements are about how your normal work affects or would affect your back pain.
[select name="Q6" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 6. My pain was caused by my work or by an accident at work
[select name="Q7" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 7. My work aggravated my pain
[select name="Q8" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 8. I have a claim for compensation for my pain
[select name="Q9" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 9. My work is too heavy for me
[select name="Q10" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 10. My work makes or would make my pain worse
[select name="Q11" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 11. My work might harm my back
[select name="Q12" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 12. I should not do my normal work with my present pain
[select name="Q13" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 13. I cannot do my normal work with my present pain
[select name="Q14" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 14. I cannot do my normal work until my pain is treated
[select name="Q15" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 15. I do not think that I will be back to my normal work within 3 months
[select name="Q16" value="completely disagree (0)=0|(1)=1|(2)=2|unsure (3)=3|(4)=4|(5)=5|completely agree (6)=6"] <-- 16. I do not think that I will ever be able to go back to that work
Physical Activity Subscale --> [calc memo="FABQPA" value="score=(Q2)+(Q3)+(Q4)+(Q5)"] out of 24 points
Work Subscale –> [calc memo="FABQW" value="score=(Q6)+(Q7)+(Q9)+(Q10)+(Q11)+(Q12)+(Q14)+(Q15)+(Q16)"] out of 42 points.
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: <a href="http://www.ncbi.nlm.nih.gov/pubmed/8455963" target="_blank">Waddell Pain. 1993 Feb;52(2):157-68.</a>[/html][/conditional]
FEAR AVOIDANCE BELIEFS QUESTIONNAIRE (FABQ)

Name: Date:
Here are some of the things which other patients have told us about their pain. For each statement please circle any number from 0 to 6 to say how much physical activities such as bending, lifting, walking or driving affect or would affect your back pain.

<-- 1. My pain was caused by physical activity
<-- 2. Physical activity makes my pain worse
<-- 3. Physical activity might harm my back
<-- 4. I should not do physical activities which (might) make my pain worse
<-- 5. I cannot do physical activities which (might) make my pain worse

The following statements are about how your normal work affects or would affect your back pain.
<-- 6. My pain was caused by my work or by an accident at work
<-- 7. My work aggravated my pain
<-- 8. I have a claim for compensation for my pain
<-- 9. My work is too heavy for me
<-- 10. My work makes or would make my pain worse
<-- 11. My work might harm my back
<-- 12. I should not do my normal work with my present pain
<-- 13. I cannot do my normal work with my present pain
<-- 14. I cannot do my normal work until my pain is treated
<-- 15. I do not think that I will be back to my normal work within 3 months
<-- 16. I do not think that I will ever be able to go back to that work
Physical Activity Subscale --> FABQPAscore=(Q2)+(Q3)+(Q4)+(Q5) out of 24 points
Work Subscale –> FABQWscore=(Q6)+(Q7)+(Q9)+(Q10)+(Q11)+(Q12)+(Q14)+(Q15)+(Q16) out of 42 points.

display/hide references
Result - Copy and paste this output:

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