Affiliations: Institut für Medizinische Psychologie der
Philipps-Universität Marburg | Abteilung Physiotherapie, Klinikum der
Philipps-Universität Marburg
Note: [] Korrespondenzadresse: Prof. Dr. phil. Dr. med. habil.
Heinz-Dieter Basler, Institut für Medizini-sche Psychologie, Bunsenstr. 3,
35037 Marburg. Tel.: 06421 28 66250; Fax: 06421 28 64881; E-mail:
basler@med.uni-marburg.de
Abstract: Decisional balance and self-efficacy determine readiness for
physical activity in the context of the Transtheoretical Model. We asked
elderly patients with low back pain which are the barriers and benefits that
make up their decisional balance. After adding frequently presented and salient
items to complement existing decisional balance scales, we examined the
dimensionality and the psychometric properties of the newly developed
instrument. A total of 170 elderly patients with a mean age of 70.3 years (SD =
4.4, range 65–83), nearly half of whom had received a diagnosis of
spondylosis, participated in diagnostic interviews that included stage of
change, decisional balance, self-efficacy, and perceived function (Hanover
Functional Disability Scale), as well as an objectively taken measure of
mobility. A principal component analysis of the decisional balance items
revealed a three-factor-solution with factor I representing the perceived
advantages (10 items, α = 0.73), factor II reflecting items that indicate
"fear avoidance beliefs" (5 items, α = 0.74), and factor III containing
items that may be summarized as "organizational barriers" (5 items, α =
0.65). The construct validity of the scale is supported by the fact that
individuals in the pre-contemplation and contemplation stages show higher fear
avoidance than those in the preparation and action stages. Moreover, fear
avoidance correlates negatively with self-efficacy and subjective and objective
measures of physical function. The fear avoidance beliefs scale appears to be
useful to supplement the traditional decisional balance scale, although its
application may be limited to the study of physical activity in individuals
with pain.
